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Comparison of Hybrid capture 2 testing at different thresholds with cytology as primary cervical screening test.

Abstract：

BACKGROUND:We evaluated the performance of primary high-risk human papillomavirus (hrHPV) testing by hybrid capture 2 (HC2) with different thresholds for positivity, in comparison with conventional cytology. METHODS:We used data of 25,871 women (aged 30-60 years) from the intervention group of the VUSA-Screen study (VU University Medical Center and Saltro laboratory population-based cervical screening study), who were screened by cytology and hrHPV. Primary outcome measure was the number of cervical intraepithelial neoplasia grade 3 or higher (CIN3+), detected within 3 years. We compared baseline cytology testing with three possible hrHPV screening strategies at different relative light unit/cutoff (RLU/CO) thresholds. RESULTS:Compared with baseline cytology testing, hrHPV DNA testing as a sole primary screening instrument did not yield a superior sensitivity, as well as lower colposcopy referral rate and lower false positivity rate at any RLU/CO threshold. The hrHPV screening at 1 RLU/CO threshold with cytology triage at baseline and at 12 months revealed the highest sensitivity for CIN3+ (relative sensitivity of 1.32), although still displaying a lower colposcopy referral rate than cytology testing (relative colposcopy rate of 0.94). Higher thresholds (>1 RLU/CO) yielded lower colposcopy rates, but resulted in substantial loss in sensitivity. CONCLUSIONS:The hrHPV testing at the commonly used threshold of 1 RLU/CO with cytology triage at baseline and at 12 months showed a much higher sensitivity with a lower colposcopy referral rate compared with cytology testing.

journal_name

Br J Cancer

journal_title

British journal of cancer

authors

Rijkaart DC,Coupe VM,van Kemenade FJ,Heideman DA,Hesselink AT,Verweij W,Rozendaal L,Verheijen RH,Snijders PJ,Berkhof J,Meijer CJ

doi

10.1038/sj.bjc.6605869

subject

Has Abstract

pub_date

2010-09-28 00:00:00

pages

939-46

issue

7

eissn

0007-0920

issn

1532-1827

pii

6605869

journal_volume

103

pub_type

杂志文章

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