Comparison of Hybrid capture 2 testing at different thresholds with cytology as primary cervical screening test.

Autor: Rijkaart DC; Department of Pathology, VU University Medical Center, P.O. Box 7057, Amsterdam 1007 MB, The Netherlands., Coupe VM, van Kemenade FJ, Heideman DA, Hesselink AT, Verweij W, Rozendaal L, Verheijen RH, Snijders PJ, Berkhof J, Meijer CJ
Jazyk: angličtina
Zdroj: British journal of cancer [Br J Cancer] 2010 Sep 28; Vol. 103 (7), pp. 939-46. Date of Electronic Publication: 2010 Aug 31.
DOI: 10.1038/sj.bjc.6605869
Abstrakt: Background: We evaluated the performance of primary high-risk human papillomavirus (hrHPV) testing by hybrid capture 2 (HC2) with different thresholds for positivity, in comparison with conventional cytology.
Methods: We used data of 25,871 women (aged 30-60 years) from the intervention group of the VUSA-Screen study (VU University Medical Center and Saltro laboratory population-based cervical screening study), who were screened by cytology and hrHPV. Primary outcome measure was the number of cervical intraepithelial neoplasia grade 3 or higher (CIN3+), detected within 3 years. We compared baseline cytology testing with three possible hrHPV screening strategies at different relative light unit/cutoff (RLU/CO) thresholds.
Results: Compared with baseline cytology testing, hrHPV DNA testing as a sole primary screening instrument did not yield a superior sensitivity, as well as lower colposcopy referral rate and lower false positivity rate at any RLU/CO threshold. The hrHPV screening at 1 RLU/CO threshold with cytology triage at baseline and at 12 months revealed the highest sensitivity for CIN3+ (relative sensitivity of 1.32), although still displaying a lower colposcopy referral rate than cytology testing (relative colposcopy rate of 0.94). Higher thresholds (>1 RLU/CO) yielded lower colposcopy rates, but resulted in substantial loss in sensitivity.
Conclusions: The hrHPV testing at the commonly used threshold of 1 RLU/CO with cytology triage at baseline and at 12 months showed a much higher sensitivity with a lower colposcopy referral rate compared with cytology testing.
Databáze: MEDLINE
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