Cervical Cancer Screening in Postmenopausal Women: Is It Time to Move Toward Primary High-Risk Human Papillomavirus Screening?
| Autor: | Terry K. Morgan, Molly E. Leonard, Jaime M. Kiff, Madisen Cotter, Elizabeth Munro, Amanda S. Bruegl |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Oncology
medicine.medical_specialty Uterine Cervical Neoplasms Atypical Squamous Cells Alphapapillomavirus Cervical intraepithelial neoplasia Cervical cancer screening 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Humans Human papillomavirus skin and connective tissue diseases Papillomaviridae Early Detection of Cancer Retrospective Studies Vaginal Smears 030219 obstetrics & reproductive medicine Postmenopausal women business.industry fungi Human papillomavirus screening Papillomavirus Infections Cervical cytology General Medicine Papanicolaou Test Original Articles medicine.disease Postmenopause 030220 oncology & carcinogenesis DNA Viral Female sense organs business |
| Zdroj: | J Womens Health (Larchmt) |
| ISSN: | 1931-843X |
| Popis: | Background: Cervical cytology in postmenopausal women is challenging due to physiologic changes of the hypoestrogenic state. Misinterpretation of an atrophic smear as atypical squamous cells of uncertain significance (ASCUS) is one of the most common errors. We hypothesize that high-risk human papillomavirus (hrHPV) testing may be more accurate with fewer false positive results than co-testing of hrHPV and cervical cytology for predicting clinically significant cervical dysplasia in postmenopausal women. Materials and Methods: We conducted a retrospective analysis of 924 postmenopausal and 543 premenopausal women with cervical Pap smears and hrHPV testing. Index Pap smear diagnoses (ASCUS or greater vs. negative for intraepithelial lesion) and hrHPV testing results were compared with documented 5-year clinical outcomes to evaluate sensitivity and specificity of hrHPV compared with co-testing. Proportions of demographic factors were compared between postmenopausal women who demonstrated hrHPV clearance versus persistence. Results: The prevalence of hrHPV in premenopausal and postmenopausal women was 41.6% and 11.5%, respectively. The specificity of hrHPV testing (89.6% [87.4–91.5]) was significantly greater compared with co-testing (67.4% [64.2–70.4]) (p |
| Databáze: | OpenAIRE |
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