Randomized Implementation of a Primary Human Papillomavirus Testing-based Cervical Cancer Screening Protocol for Women 34 to 69 Years in Norway.

Autor:	Nygård M; The Cancer Registry of Norway, Oslo, Norway., Engesæter B; The Cancer Registry of Norway, Oslo, Norway., Castle PE; Division of Cancer Prevention, NCI, NIH, Rockville, Maryland.; Division of Cancer Epidemiology and Genetics, NCI, NIH, Rockville, Maryland., Berland JM; Stavanger University Hospital, Stavanger, Rogaland., Eide ML; Trondheim University Hospital, Trondheim, Norway., Iversen OE; Institute of Clinical Science, University of Bergen, Bergen, Norway.; Haukeland University Hospital, Bergen, Norway., Jonassen CM; Center for Laboratory Medicine, Østfold Hostpital Trust, Grålum, Norway., Christiansen IK; Akershus University Hospital, Lørenskog, Norway., Vintermyr OK; Haukeland University Hospital, Bergen, Norway.; The Gades Laboratory for Pathology, University of Bergen, Bergen, Norway., Tropé A; The Cancer Registry of Norway, Oslo, Norway.
Jazyk:	angličtina
Zdroj:	Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology [Cancer Epidemiol Biomarkers Prev] 2022 Sep 02; Vol. 31 (9), pp. 1812-1822.
DOI:	10.1158/1055-9965.EPI-22-0340
Abstrakt:	Background: Cervical cancer screening programs are facing a programmatic shift where screening protocol based on human papillomavirus testing (HPV-Screening protocol) is replacing the liquid-based cytology (LBC-Screening protocol). For safe technology transfer within the nationwide screening programme in Norway, HPV-Screening protocol was implemented randomized to compare the real-world effectiveness of HPV-Screening protocol and LBC-Screening protocol at the first screening round. Methods: Among 302,295 women ages 34 to 69 years scheduled to attend screening from February 2015 to June 2017, 157,447 attended. A total of 77,207 were randomly allocated to the HPV-Screening protocol and 80,240 were allocated to the LBC-Screening protocol. All women were followed up for 18 months. Results: The HPV-Screening protocol resulted in a relative increase of 60% in the detection of cervical intraepithelial neoplasia (CIN) grade 2 or worse [risk ratio (RR) = 1.6, 95% confidence interval (CI) = 1.5-1.7], 40% in CIN grade 3 or worse (RR = 1.4, 95% CI = 1.3-1.6), 40% in cancer (RR = 1.4, 95% CI = 1.0-2.1), and 60% in colposcopy referrals (RR = 1.6, 95% CI = 1.5-1.6) compared with LBC-Screening. The performance of both protocols was age dependent, being more effective in women ages under 50 years. Conclusions: The HPV-Screening protocol was well accepted by women in Norway and detected more CIN2, CIN3, and cancers compared with the LBC-Screening protocol. Impact: A randomized implementation of the HPV-Screening protocol with real-world assessment enabled a gradual, quality assured, and safe technology transition. HPV-based screening protocol may further be improved by using HPV genotyping and age-specific referral algorithms. (©2022 The Authors; Published by the American Association for Cancer Research.)
Databáze:	MEDLINE
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