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Population-based primary HPV mRNA cervical screening compared with cytology screening

Lindroth, Ylva LU ; Borgfeldt, Christer LU ; Thorn, Gunilla ; Bodelsson, Gunilla LU and Forslund, Ola LU (2019) In Preventive Medicine 124. p.61-66
Abstract

Primary HPV screening for cervical cancer by HPV mRNA testing (Aptima)was implemented in January 2017, for women ≥30 through 70 years, in the Region of Skåne, Sweden. HPV positive samples underwent cytology assessment, and women with any degree of abnormal cytology were referred for colposcopy. The aim was to audit the primary HPV screening program, by comparing the cytology results to those of corresponding women (aged ≥30 through 65 years)screened with conventional cytology during 2016. Overall, HPV was detected among 7.0% (4433/63,055)of the women ≥30–70 years in the primary HPV screening program. Among a co-tested (cytology and HPV)subgroup aged 40–42 years (N = 5039), HPV was detected in 100% (28/28)of high-grade squamous... (More)

Primary HPV screening for cervical cancer by HPV mRNA testing (Aptima)was implemented in January 2017, for women ≥30 through 70 years, in the Region of Skåne, Sweden. HPV positive samples underwent cytology assessment, and women with any degree of abnormal cytology were referred for colposcopy. The aim was to audit the primary HPV screening program, by comparing the cytology results to those of corresponding women (aged ≥30 through 65 years)screened with conventional cytology during 2016. Overall, HPV was detected among 7.0% (4433/63,055)of the women ≥30–70 years in the primary HPV screening program. Among a co-tested (cytology and HPV)subgroup aged 40–42 years (N = 5039), HPV was detected in 100% (28/28)of high-grade squamous intraepithelial lesions (HSIL)and atypical squamous cells of undetermined significance (ASCUS)where HSIL could not be excluded (ASC[sbnd]H)(9/9), and in 80% (4/5)of cases of atypical glandular cells (AGC). Among women ≥30–65 years, the proportion ASCUS or worse (ASCUS+)was similar with cytology (3.52% [2016])and primary HPV screening (3.70% [2017]). Only the proportion of ASC-H changed by the use of primary HPV screening, from 0.13% (2016)to 0.23% (2017)(p < 0.001). The colposcopy referral rate increased by 54% (3.70 vs 2.41%), when primary HPV screening was introduced. In conclusion, the implemented primary HPV screening approach demonstrated similar prevalence of ASCUS+ cytology as conventional screening. In addition, primary HPV screening decreased cytology assessments by 86% in our screening population of women 30 through 70 years taken into account the co-tested women.

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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Cervical, Cytology, HPV-mRNA, Screening
in
Preventive Medicine
volume
124
pages
6 pages
publisher
Elsevier
external identifiers
  • scopus:85065430001
  • pmid:31047910
ISSN
0091-7435
DOI
10.1016/j.ypmed.2019.04.021
language
English
LU publication?
yes
id
a38a8e19-56ee-46b7-a8f2-50178a8ac751
date added to LUP
2019-05-22 10:03:48
date last changed
2024-04-16 06:39:09
@article{a38a8e19-56ee-46b7-a8f2-50178a8ac751,
  abstract     = {{<p>Primary HPV screening for cervical cancer by HPV mRNA testing (Aptima)was implemented in January 2017, for women ≥30 through 70 years, in the Region of Skåne, Sweden. HPV positive samples underwent cytology assessment, and women with any degree of abnormal cytology were referred for colposcopy. The aim was to audit the primary HPV screening program, by comparing the cytology results to those of corresponding women (aged ≥30 through 65 years)screened with conventional cytology during 2016. Overall, HPV was detected among 7.0% (4433/63,055)of the women ≥30–70 years in the primary HPV screening program. Among a co-tested (cytology and HPV)subgroup aged 40–42 years (N = 5039), HPV was detected in 100% (28/28)of high-grade squamous intraepithelial lesions (HSIL)and atypical squamous cells of undetermined significance (ASCUS)where HSIL could not be excluded (ASC[sbnd]H)(9/9), and in 80% (4/5)of cases of atypical glandular cells (AGC). Among women ≥30–65 years, the proportion ASCUS or worse (ASCUS+)was similar with cytology (3.52% [2016])and primary HPV screening (3.70% [2017]). Only the proportion of ASC-H changed by the use of primary HPV screening, from 0.13% (2016)to 0.23% (2017)(p &lt; 0.001). The colposcopy referral rate increased by 54% (3.70 vs 2.41%), when primary HPV screening was introduced. In conclusion, the implemented primary HPV screening approach demonstrated similar prevalence of ASCUS+ cytology as conventional screening. In addition, primary HPV screening decreased cytology assessments by 86% in our screening population of women 30 through 70 years taken into account the co-tested women.</p>}},
  author       = {{Lindroth, Ylva and Borgfeldt, Christer and Thorn, Gunilla and Bodelsson, Gunilla and Forslund, Ola}},
  issn         = {{0091-7435}},
  keywords     = {{Cervical; Cytology; HPV-mRNA; Screening}},
  language     = {{eng}},
  pages        = {{61--66}},
  publisher    = {{Elsevier}},
  series       = {{Preventive Medicine}},
  title        = {{Population-based primary HPV mRNA cervical screening compared with cytology screening}},
  url          = {{http://dx.doi.org/10.1016/j.ypmed.2019.04.021}},
  doi          = {{10.1016/j.ypmed.2019.04.021}},
  volume       = {{124}},
  year         = {{2019}},
}