| Autor: |
Rebolj, M., Mathews, C.S., Pesola, F., Cuschieri, K., Denton, K., Kitchener, H., Appleyard, T., Cruickshank, M., Ellis, K., Evans, C., Frew, V., Giles, T., Gray, A., Holbrook, M., Hunt, K., Levine, T., McBride, E., Mesher, D., Palmer, T., Parker, J., Rimmer, E., Pickard, H.R., Sargent, A., Smith, D., Smith, J., Soldan, K., Stubbs, R., Tidy, J., Tyler, X., Waller, J. |
| Jazyk: |
angličtina |
| Rok vydání: |
2022 |
| ISSN: |
1470-0328 |
| Popis: |
Objective\ud \ud To report detailed age-specific outcomes from the first round of an English pilot studying the implementation of high-risk human papillomavirus (HR-HPV) testing in primary cervical screening.\ud \ud \ud \ud Design\ud \ud Observational study with screening in 2013–2016, followed by two early recalls and/or colposcopy until the end of 2019.\ud \ud \ud \ud Setting\ud \ud Six NHS laboratory sites.\ud \ud \ud \ud Population\ud \ud A total of 1 341 584 women undergoing screening with HR-HPV testing or liquid-based cytology (LBC).\ud \ud \ud \ud Methods\ud \ud Early recall tests and colposcopies were recommended, depending on the nature of the screening-detected abnormality.\ud \ud \ud \ud Main outcome measures\ud \ud We reported standard screening process indicators, e.g. proportions with an abnormality, including high-grade cervical intraepithelial neoplasia (CIN2+) or cancer, and the positive predictive value (PPV) of colposcopy for CIN2+, by screening test and age group.\ud \ud \ud \ud Results\ud \ud Among unvaccinated women screened with HR-HPV testing at age 24–29 years, 26.9% had a positive test and 10.4% were directly referred to colposcopy following cytology triage, with a PPV for CIN2+ of 47%. At 50–64 years of age, these proportions were much lower: 5.3%, 1.2% and 27%, respectively. The proportions of women testing positive for HR-HPV without cytological abnormalities, whose early recall HR-HPV tests returned negative results, were similar across the age spans: 54% at 24–29 years and 55% at 50–64 years. Two-thirds of infections at any age were linked to non-16/18 genotypes. Among women with CIN2, CIN3 or cervical cancer, however, the proportion of non-16/18 infections increased with age. As expected, the detection of abnormalities was lower following screening with LBC.\ud \ud \ud \ud Conclusions\ud \ud These data provide a reliable reference for future epidemiological studies, including those concerning the effectiveness of HPV vaccination. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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