Population-based e-records to evaluate HPV triage of screen-detected atypical squamous cervical lesions in Catalonia, Spain, 2010–15
| Autor: | Xavier Bosch, Vanesa Rodríguez-Salés, Raquel Ibáñez, Laia Bruni, Silvia de Sanjosé |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Viral Diseases
lcsh:Medicine Pathology and Laboratory Medicine Cervical Cancer 0302 clinical medicine Cervix cancer Cytology Cancer screening Medicine and Health Sciences Electronic Health Records Mass Screening Medicine 030212 general & internal medicine lcsh:Science Papillomaviridae Cervical cancer education.field_of_study Multidisciplinary Screen detected Obstetrics Middle Aged Infectious Diseases Cribratge Oncology Medical Microbiology Viral Pathogens 030220 oncology & carcinogenesis Viruses Female Electronic data Squamous Intraepithelial Lesions of the Cervix Pathogens Cancer Screening Research Article Adult Human Papillomavirus Infection medicine.medical_specialty Càncer de coll uterí Papillomaviruses Medical screening Urology Population Sexually Transmitted Diseases Citologia Population based Microbiology 03 medical and health sciences Signs and Symptoms Diagnostic Medicine Cancer Detection and Diagnosis Humans Papil·lomavirus education Microbial Pathogens Aged Biology and life sciences Genitourinary Infections business.industry lcsh:R Organisms Human Papillomavirus Cancers and Neoplasms Cell Biology medicine.disease Triage Age Groups Spain People and Places Lesions Population Groupings lcsh:Q DNA viruses business Gynecological Tumors |
| Zdroj: | Dipòsit Digital de la UB Universidad de Barcelona PLoS ONE, Vol 13, Iss 11, p e0207812 (2018) PLoS ONE |
| ISSN: | 1932-6203 |
| DOI: | 10.1371/journal.pone.0207812 |
| Popis: | Equivocal lesions (ASC-US) are common abnormalities in cervical cancer screening exams. HPV testing helps to stratify the risk of progression to high-grade squamous intraepithelial lesions or more (HSIL+). Population-based medical electronic data can be used to evaluate screening recommendations. The study uses routine electronic data from primary health centers to estimate the impact of HPV testing in a 3- and a 5-year risk of HSIL+ after an ASC-US. The study includes data derived from medical electronic information from 85,775 women who first attended a cervical cancer screening visit at the National Health System facilities of Catalonia, Spain, during 2010-11 and followed up to 2015. Included women were aged between 25-65 years old, having at least one follow-up visit, and a cervical cytology of ASC-US (N = 1,647). Women with a first result of low-grade squamous intraepithelial lesions (LSIL) (N = 945) or those with negative cytology (N = 83,183) were included for comparison. Those with a baseline HSIL+ were excluded. Incident HSIL+ was evaluated by means of Kaplan-Meier curves and multivariate regression models. HPV test results were available for 63.4% of women with a baseline ASC-US. Among all ASC-US, 70 incident HSIL+ were identified at 5 years. ASC-US HPV positive women had a high risk of HSIL+ compared to women with negative cytology (adjusted HR = 32.7; 95% CI: 23.6-45.2) and a similar risk to women with baseline LSIL (HR = 29.3; 95% CI: 22.4-38.2), whereas ASC-US HPV negative women had no differential risk to that observed in baseline negative cytology. Women with ASC-US and no HPV test had an average HSIL+ risk (HR = 14.8; 95% CI: 9.7-22.5). Population-based e-medical records derived from primary health care centers allowed monitoring of screening recommendations, providing robust estimates for the study outcomes. This analysis confirms that HPV testing improved risk stratification of ASC-US lesions. The information can be used to improve diagnosis and management of screen detected lesions. |
| Databáze: | OpenAIRE |
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