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Implementation of HPV ‐based cervical cancer screening in an organised regional screening programme: 3 years of experience
Author(s) -
Veijalainen Olga,
Kares Saara,
Kujala Paula,
Vuento Risto,
Osuala Veronika,
Tirkkonen Mika,
Luukkaala Tiina,
Kholová Ivana,
Mäenpää Johanna
Publication year - 2019
Publication title -
cytopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.512
H-Index - 48
eISSN - 1365-2303
pISSN - 0956-5507
DOI - 10.1111/cyt.12652
Subject(s) - medicine , colposcopy , cytology , triage , papanicolaou stain , cervical intraepithelial neoplasia , papanicolaou test , gynecology , cervical cancer , obstetrics , pap test , confidence interval , cervical screening , cervical cancer screening , cancer , pathology , emergency medicine
Objective The aim of this study was to evaluate the performance of human papillomavirus ( HPV )‐based screening in the framework of an organised cervical cancer screening programme. Methods A total of 46 708 women aged 35‐60 years invited to the regional cervical cancer screening programme from 1 January 2012, to 31 December 2014, were enrolled. Overall, 17 770 women were screened by the Abbot RealTime hr HPV test with cytology triage and 15 605 were screened by conventional (Papanicolaou, Pap) cytology. In both groups, women with at least low‐grade squamous intraepithelial lesions were referred directly for colposcopy, whereas HPV ‐positive women with borderline or normal cytology were invited to intensified screening in the following year. In the Pap group, the indication for intensified follow‐up was borderline cytology. Results The attendance rate was similar in the HPV and Pap groups (72% and 71%, respectively). Overall, 6.0% of women in the HPV group vs 6.4% in the Pap group were referred to intensified follow‐up (relative risk 0.94, 95% confidence interval [ CI] : 0.87‐1.03). At the index screening years, the relative sensitivity of the HPV test with cytology triage vs conventional screening was 1.64 (95% CI : 1.05‐2.55) for CIN 2+ and 2.06 (95% CI : 1.17‐3.41) for CIN 3+. The specificity of the hr HPV test with cytology triage for CIN 2+ and CIN 3+ was equal to that of the Pap screening (99.2% vs 99.2% for CIN 2+ and 99.1% vs 99.1% for CIN 3+). Conclusions Due to its high sensitivity and specificity, primary hr HPV testing with cytology triage seems to be acceptable for cervical cancer screening in an organised setting.