HPV for cervical cancer screening (HPV FOCAL): Complete Round 1 results of a randomized trial comparing HPV-based primary screening to liquid-based cytology for cervical cancer
| Autor: | Marette Lee, Andrew J. Coldman, Eduardo L. Franco, Darrel Cook, Gavin Stuart, Lovedeep Gondara, Laurie Smith, Laura Gentile, Stuart Peacock, Mel Krajden, Kathy Ceballos, Gina Ogilvie, Ruth Elwood-Martin, Dirk van Niekerk |
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| Rok vydání: | 2016 |
| Předmět: |
Cancer Research
medicine.medical_specialty Population Cervical intraepithelial neoplasia law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law Internal medicine Cytology medicine 030212 general & internal medicine education Cervix Colposcopy Gynecology Cervical cancer education.field_of_study medicine.diagnostic_test business.industry medicine.disease female genital diseases and pregnancy complications medicine.anatomical_structure Oncology 030220 oncology & carcinogenesis Liquid-based cytology business |
| Zdroj: | International Journal of Cancer. 140:440-448 |
| ISSN: | 0020-7136 |
| Popis: | Complete Round 1 data (baseline and 12 month follow-up) for HPV FOCAL, a randomized trial establishing the efficacy of HPV DNA testing with cytology triage as a primary screen for cervical cancer are presented. Women were randomized to one of three arms: Control arm- Baseline liquid-based cytology (LBC) with ASCUS results triaged with HPV testing; Intervention and Safety arms- Baseline HPV with LBC triage for HPV positives. Results are presented for 15,744 women allocated to the HPV (intervention and safety combined) and 9,408 to the control arms. For all age cohorts, the CIN3+ detection rate was higher in the HPV (7.5/1000; 95% CI: 6.2, 8.9) compared to the control arm (4.6/1000; 95% CI: 3.4, 6.2). The CIN2+ detection rates were also significantly higher in the HPV (16.5/1000; 95% CI: 14.6, 18.6) vs. the control arm (10.1/1000; 95%CI: 8.3, 12.4). In women ≥35yrs, the overall detection rates for CIN2+ and CIN3+ were higher in the HPV vs. the control arm (CIN2+:10.0/1000 vs. 5.2/1000; CIN3+: 4.2/1000 vs. 2.2/1000 respectively, with a statistically significant difference for CIN2+). HPV testing detected significantly more CIN2+ in women 25-29 compared to LBC (63.7/1000; 95%CI: 51.9, 78.0 vs. 32.4/1000; 95%CI: 22.3, 46.8). HPV testing resulted in significantly higher colposcopy referral rates for all age cohorts (HPV: 58.9/1000; 95% CI: 55.4, 62.7 vs. control: 30.9/1000; 95% CI: 27.6, 34.6). At completion of Round 1 HPV-based cervical cancer screening in a population-based program resulted in greater CIN2+ detection of across all age cohorts compared to LBC screening. This article is protected by copyright. All rights reserved. |
| Databáze: | OpenAIRE |
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