Evaluation of partial genotyping with HPV16/18 for triage of HPV positive, cytology negative women in the COMPACT study.

Autor: Hanley SJB; Department of Obstetrics and Gynecology, Hokkaido University Faculty of Medicine, Sapporo, Japan.; Hokkaido Center for Environmental and Health Sciences, Sapporo, Japan. sjbh1810@med.hokudai.ac.jp., Fujita H; Hokkaido Cancer Society, Sapporo, Japan., Aoyama-Kikawa S; Women's Healthcare Center, Otaru General Hospital, Otaru, Japan., Kasamo M; Hokkaido Cancer Society, Asahikawa, Japan., Torigoe T; Department of Pathology, Sapporo Medical University, Sapporo, Japan., Matsuno Y; Department of Surgical Pathology, Hokkaido University Hospital, Sapporo, Japan., Noriaki S; Department of Obstetrics and Gynecology, Hokkaido University Faculty of Medicine, Sapporo, Japan.; Women's Healthcare Center, Otaru General Hospital, Otaru, Japan.
Jazyk: angličtina
Zdroj: Journal of gynecologic oncology [J Gynecol Oncol] 2021 Nov; Vol. 32 (6), pp. e86.
DOI: 10.3802/jgo.2021.32.e86
Abstrakt: Objective: While cytology-based screening programs have significantly reduced mortality and morbidity from cervical cancer, the global consensus is that primary human papillomavirus (HPV) testing increases detection of high-grade cervical intraepithelial neoplasia (CIN) and invasive cancer. However, the optimal triage strategy for HPV+ women to avoid over-referral to colposcopy may be setting specific. We compared absolute and relative risk (RR) of >CIN2/3 within 12 months of a negative cytologic result in women HPV16/18+ compared to those with a 12-other high-risk HPV (hrHPV) genotype to identify women at greatest risk of high-grade disease and permit less aggressive management of women with other hrHPV infections.
Methods: Participants were 14,160 women aged 25-69 years with negative cytology participating in the COMparison of HPV genotyping And Cytology Triage (COMPACT) study. Women who were HPV16/18+ were referred to colposcopy. Those with a 12-other hrHPV type underwent repeat cytology after 6 months and those with >abnormal squamous cells of undetermined significance went to colposcopy.
Results: Absolute risk of >CIN2 in HPV16/18+ women was 19.5% (95% CI=12.4%-29.4%). In women 25-29 years and HPV16+ it was 40.0% (95% CI=11.8%-76.9%). Absolute risk of >CIN3 in women HPV16/18+ was 11.0% (95% CI=5.9%-19.6%). For women 30-39 years and HPV16+ it was 23.1% (95% CI=5.0%-53.8%). Overall risk of >CIN2, >CIN3 in women with a 12-other hrHPV HPV type was 5.6% (95% CI=3.1%-10.0%) and 3.4% (95% CI=1.6%-7.2%) respectively. RR of >CIN2, >CIN3 in HPV16/18+ vs. 12-other hrHPV was 3.5 (95% CI=1.7-7.3) and 3.3 (95% CI=1.2-8.8), respectively.
Conclusion: Primary HPV screening with HPV16/18 partial genotyping is a promising strategy to identify women at current/future risk of >CIN2 in Japan without over-referral to colposcopy.
Trial Registration: Trial Registration: UMIN Clinical Trials Registry Identifier: UMIN000013203.
Competing Interests: SK, SJBH, KK, TT, YM, AT, TS, MM, YK, HW, declare no conflict of interest. HF declares receiving grants from Roche Diagnostics and Qiagen Japan and lecture fees from Roche Diagnostics. NS declares receiving grants and lecture fees from Roche Diagnostics. MK, ST, SK declare receiving grants from Roche Diagnostics. YK declares receiving lecture fees from Roche Diagnostics. Roche Diagnostics provided the HPV assays, funding for colposcopy when it was not covered by national health insurance and travel compensation for colposcopy. Roche Diagnostics had no role in the data analysis or writing up of the study.
(Copyright © 2021. Asian Society of Gynecologic Oncology, Korean Society of Gynecologic Oncology, and Japan Society of Gynecologic Oncology.)
Databáze: MEDLINE
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