Liang, Linda A., Einzmann, Thomas, Franzen, Arno, Schwarzer, Katja, Schauberger, Gunther ORCID: 0000-0002-0392-1580, Schriefer, Dirk ORCID: 0000-0002-7524-7628, Radde, Kathrin, Zeissig, Sylke R., Ikenberg, Hans, Meijer, Chris J. L. M., Kirkpatrick, Charles J., Koelbl, Heinz, Blettner, Maria and Klug, Stefanie J. ORCID: 0000-0003-3523-1362 (2021). Cervical Cancer Screening: Comparison of Conventional Pap Smear Test, Liquid-Based Cytology, and Human Papillomavirus Testing as Stand-alone or Cotesting Strategies. Cancer Epidemiol. Biomarkers Prev., 30 (3). S. 474 - 485. PHILADELPHIA: AMER ASSOC CANCER RESEARCH. ISSN 1538-7755
Full text not available from this repository.Abstract
Background: Some countries have implemented stand-alone human papillomavirus (HPV) testing while others consider cotesting for cervical cancer screening. We compared both strategies within a population-based study. Methods: The MARZY cohort study was conducted in Germany. Randomly selected women from population registries aged >= 30 years (n = 5,275) were invited to screening with Pap smear, liquid-based cytology (LBC, ThinPrep), and HPV testing (Hybrid Capture2, HC2). Screen-positive participants [ASC-US+ or high-risk HC2 (hrHC2)] and a random 5% sample of screen-negatives were referred to colposcopy. Post hoc HPV genotyping was conducted by GP5+/6+ PCR-EIA with reverse line blotting. Sensitivity, specificity (adjusted for verification bias), and potential harms, including number of colposcopies needed to detect 1 precancerous lesion (NNC), were calculated. Results: In 2,627 screened women, cytological sensitivities (Pap, LBC: 47%) were lower than HC2 (95%) and PCR (79%) for CIN2+. Cotesting demonstrated higher sensitivities (HC2 cotesting: 99%; PCR cotesting: 84%), but at the cost of lower specificities (92%-95%) compared with HPV stand-alone (HC2: 95%; PCR: 94%) and cytology (97% or 99%). Cotesting versus HPV stand-alone showed equivalent relative sensitivity [HC2: 1.06, 95% confidence interval (CI), 1.00-1.21; PCR: 1.07, 95% CI, 1.00-1.27]. Relative specificity of Pap cotesting with either HPV test was inferior to stand-alone HPV. LBC cotesting demonstrated equivalent specificity (both tests: 0.99, 95% CI, 0.99-1.00). NNC was highest for Pap cotesting. Conclusions: Cotesting offers no benefit in detection over stand-alone HPV testing, resulting in more false positive results and colposcopy referrals. Impact: HPV stand-alone screening offers a better balance of benefits and harms than cotesting.
Item Type: | Journal Article | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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URN: | urn:nbn:de:hbz:38-599038 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
DOI: | 10.1158/1055-9965.EPI-20-1003 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Journal or Publication Title: | Cancer Epidemiol. Biomarkers Prev. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Volume: | 30 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Number: | 3 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Page Range: | S. 474 - 485 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Date: | 2021 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Publisher: | AMER ASSOC CANCER RESEARCH | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Place of Publication: | PHILADELPHIA | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
ISSN: | 1538-7755 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Language: | English | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Faculty: | Unspecified | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Divisions: | Unspecified | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Subjects: | no entry | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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URI: | http://kups.ub.uni-koeln.de/id/eprint/59903 |
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