Open AccessComparison of human papillomavirus genotyping and cytology triage, COMPACT Study: Design, methods and baseline results in 14 642 women
Author(s) -
AoyamaKikawa Satomi,
Fujita Hiromasa,
Hanley Sharon J.B.,
Kasamo Mitsunori,
Kikuchi Kokichi,
Torigoe Toshihiko,
Matsuno Yoshihiro,
Tamakoshi Akiko,
Sasaki Takayuki,
Matsuura Motoki,
Kato Yasuhito,
Dong Peixin,
Watari Hidemichi,
Saito Tsuyoshi,
Sengoku Kazuo,
Sakuragi Noriaki
Publication year - 2018
Publication title -
cancer science
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.035
H-Index - 141
eISSN - 1349-7006
pISSN - 1347-9032
DOI - 10.1111/cas.13608
Subject(s) - colposcopy , cytology , medicine , genotyping , cervical intraepithelial neoplasia , cervical cancer , triage , gynecology , hpv infection , obstetrics , cervical screening , cancer , pathology , genotype , biology , gene , emergency medicine , biochemistry
Although cytology‐based screening programs have significantly reduced mortality and morbidity from cervical cancer, the global consensus is that primary human papillomavirus ( HPV ) testing for cervical screening increases detection of high‐grade cervical intraepithelial neoplasia ( CIN ) and invasive cancer. However, the optimal triage strategy for HPV ‐positive women to avoid over‐referral to colposcopy may be setting specific. As Japan requires data that have been generated domestically to modify screening guidelines, we conducted a 3‐year prospective study, COM parison of HPV genotyping And Cytology Triage ( COMPACT ), to evaluate the potential role of HPV 16/18 partial genotyping and cytology for primary HPV screening. In total, 14 642 women aged 20 to 69 years undergoing routine screening at 3 centers in Hokkaido were enrolled. Conventional cytology and HPV testing were carried out. Women with abnormal cytology or HPV 16/18 positivity underwent colposcopy. Those with 12 other high‐risk (hr) HPV types underwent repeat cytology after 6 months. Primary study endpoints were detection of high‐grade cervical disease defined as CIN 2/ CIN 3 or greater as determined by consensus pathology. Prevalence of cytological abnormalities was 2.4%. hr HPV , HPV 16, and HPV 18 were detected in 4.6%, 0.9%, and 0.3% of women, respectively. HPV 16/18 were detected in all (8/8) invasive cervical cancers and in all (2/2) adenocarcinomas in situ. Both cytological abnormalities and hr HPV positivity declined with increasing age. This is the first Japanese study to investigate the role of partial genotyping and cytology in an HPV ‐based screening program. Results should help policy‐makers develop guidelines for future cervical screening programs and management of cervical abnormalities based on HPV genotype.