Chapter 9: Clinical applications of HPV testing: a summary of meta-analyses - PubMed (original) (raw)
Review
Chapter 9: Clinical applications of HPV testing: a summary of meta-analyses
Marc Arbyn et al. Vaccine. 2006.
Abstract
Background: More than ever, clinicians need regularly updated reviews given the continuously increasing amount of new information regarding innovative cervical cancer prevention methods.
Material and methods: A summary is given from recently published meta-analyses on three possible clinical applications of human papillomavirus (HPV)-DNA testing: triage of women with equivocal or low-grade cytological abnormalities; prediction of the therapeutic outcome after treatment of cervical intraepithelial neoplasia (CIN) lesions, and last not but not least, primary screening for cervical cancer and pre-cancer.
Results: Consistent evidence is available indicating that HPV-triage with the Hybrid Capture-2 assay (HC2) is more accurate (significantly higher sensitivity, similar specificity) than repeat cytology to triage women with equivocal Pap smear results. When triaging women with low-grade squamous intraepithelial lesions (LSIL), a reflex HC2 test does not show a significantly higher sensitivity, but a significantly lower specificity compared to a repeat Pap smear. After treatment of cervical lesions, HPV testing easily detects (with higher sensitivity and not lower specificity) residual or recurrent CIN than follow-up cytology. Primary screening with HC2 generally detects 23% (95% confidence interval, CI: 13-23%) more CIN-2, CIN-3, or cancer compared to cytology at cut-off atypical squamous cells of undetermined significance (ASCUS) or LSIL, but is 6% (95% CI: 4-8%) less specific. By combined HPV and cytology screening, a further 4% (95% CI: 3-5%) more CIN-3 lesions can be identified but at the expense of a 7% (95% CI: 5-9%) loss in specificity, in comparison with isolated HC2 screening.
Conclusions: Sufficient evidence exists to recommend HPV testing in triage of women with atypical cytology and in surveillance after treatment of CIN lesions. In the United States, recently reviewed knowledge has resulted in the approval of combined cytology and HC2 primary screening in women older than 30 years. However, in Europe, cytology-based screening still remains the standard screening method. The European screening policy will be reviewed based on the longitudinal results of randomised population trials which are currently underway.
Similar articles
- Evidence regarding human papillomavirus testing in secondary prevention of cervical cancer.
Arbyn M, Ronco G, Anttila A, Meijer CJ, Poljak M, Ogilvie G, Koliopoulos G, Naucler P, Sankaranarayanan R, Peto J. Arbyn M, et al. Vaccine. 2012 Nov 20;30 Suppl 5:F88-99. doi: 10.1016/j.vaccine.2012.06.095. Vaccine. 2012. PMID: 23199969 Review. - Comparison of HPV test versus conventional and automation-assisted Pap screening as potential screening tools for preventing cervical cancer.
Nieminen P, Vuorma S, Viikki M, Hakama M, Anttila A. Nieminen P, et al. BJOG. 2004 Aug;111(8):842-8. doi: 10.1111/j.1471-0528.2004.00210.x. BJOG. 2004. PMID: 15270934 - Overview of human papillomavirus-based and other novel options for cervical cancer screening in developed and developing countries.
Cuzick J, Arbyn M, Sankaranarayanan R, Tsu V, Ronco G, Mayrand MH, Dillner J, Meijer CJ. Cuzick J, et al. Vaccine. 2008 Aug 19;26 Suppl 10:K29-41. doi: 10.1016/j.vaccine.2008.06.019. Vaccine. 2008. PMID: 18847555 Review. - Human papillomavirus testing versus repeat cytology for triage of minor cytological cervical lesions.
Arbyn M, Roelens J, Simoens C, Buntinx F, Paraskevaidis E, Martin-Hirsch PP, Prendiville WJ. Arbyn M, et al. Cochrane Database Syst Rev. 2013 Mar 28;2013(3):CD008054. doi: 10.1002/14651858.CD008054.pub2. Cochrane Database Syst Rev. 2013. PMID: 23543559 Free PMC article. Review. - Comparison between the Hybrid Capture 2 and the hpVIR real-time PCR for detection of human papillomavirus in women with ASCUS or low grade dysplasia.
Gustavsson I, Juko-Pecirep I, Backlund I, Wilander E, Gyllensten U. Gustavsson I, et al. J Clin Virol. 2009 Jun;45(2):85-9. doi: 10.1016/j.jcv.2009.04.012. Epub 2009 May 17. J Clin Virol. 2009. PMID: 19451022
Cited by
- Assessing generalizability of an AI-based visual test for cervical cancer screening.
Ahmed SR, Egemen D, Befano B, Rodriguez AC, Jeronimo J, Desai K, Teran C, Alfaro K, Fokom-Domgue J, Charoenkwan K, Mungo C, Luckett R, Saidu R, Raiol T, Ribeiro A, Gage JC, de Sanjose S, Kalpathy-Cramer J, Schiffman M. Ahmed SR, et al. PLOS Digit Health. 2024 Oct 2;3(10):e0000364. doi: 10.1371/journal.pdig.0000364. eCollection 2024 Oct. PLOS Digit Health. 2024. PMID: 39356713 Free PMC article. - Accuracy of GynTect® Methylation Markers to Detect Recurrent Disease in Patients Treated for CIN3: A Proof-of-Concept Case-Control Study.
Hoyer H, Scheungraber C, Mehlhorn G, Hagemann I, Scherbring S, Wölber L, Petzold A, Wunsch K, Schmitz M, Hampl M, Böhmer G, Hillemanns P, Runnebaum IB, Dürst M. Hoyer H, et al. Cancers (Basel). 2024 Aug 30;16(17):3022. doi: 10.3390/cancers16173022. Cancers (Basel). 2024. PMID: 39272880 Free PMC article. - Clinical Validation of the Vitro HPV Screening Assay for Its Use in Primary Cervical Cancer Screening.
Bellosillo B, Ibáñez R, Roura E, Monfil L, Asensio-Puig L, Álvarez I, Muset M, Florencia Y, Paytubi S, de Andrés-Pablo Á, Calvo S, Serrano-Munné L, Pavón MÁ, Lloveras B. Bellosillo B, et al. Cancers (Basel). 2024 Mar 28;16(7):1322. doi: 10.3390/cancers16071322. Cancers (Basel). 2024. PMID: 38611001 Free PMC article. - Human Papillomavirus Infection (HPV) Prevalence in the Black Sea Region of Turkey: Primary HPV Screening for Cervical Cancer.
Dura MC, Aktürk H, Aslan Ö, Yıldız Ş, Kefeli M, Çelik H. Dura MC, et al. Cureus. 2024 Jan 20;16(1):e52615. doi: 10.7759/cureus.52615. eCollection 2024 Jan. Cureus. 2024. PMID: 38374849 Free PMC article. - Predictive Value of Various Atypical Cells for the Detection of Human Papillomavirus in Cervical Smears.
Okayama K, Kakinuma M, Teruya K, Oda M, Fujii M, Kimura H, Sasagawa T, Okodo M. Okayama K, et al. Int J Mol Sci. 2024 Jan 19;25(2):1212. doi: 10.3390/ijms25021212. Int J Mol Sci. 2024. PMID: 38279211 Free PMC article.
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Other Literature Sources
Research Materials