Rebolj, M., Mathews, C.S., Pesola, F. et al. (27 more authors) (2022) Age‐specific outcomes from the first round of HPV screening in unvaccinated women : observational study from the English cervical screening pilot. BJOG: An International Journal of Obstetrics & Gynaecology, 129 (8). pp. 1278-1288. ISSN 1470-0328
Abstract
Objective
To report detailed age-specific outcomes from the first round of an English pilot studying the implementation of high-risk human papillomavirus (HR-HPV) testing in primary cervical screening.
Design
Observational study with screening in 2013–2016, followed by two early recalls and/or colposcopy until the end of 2019.
Setting
Six NHS laboratory sites.
Population
A total of 1 341 584 women undergoing screening with HR-HPV testing or liquid-based cytology (LBC).
Methods
Early recall tests and colposcopies were recommended, depending on the nature of the screening-detected abnormality.
Main outcome measures
We reported standard screening process indicators, e.g. proportions with an abnormality, including high-grade cervical intraepithelial neoplasia (CIN2+) or cancer, and the positive predictive value (PPV) of colposcopy for CIN2+, by screening test and age group.
Results
Among unvaccinated women screened with HR-HPV testing at age 24–29 years, 26.9% had a positive test and 10.4% were directly referred to colposcopy following cytology triage, with a PPV for CIN2+ of 47%. At 50–64 years of age, these proportions were much lower: 5.3%, 1.2% and 27%, respectively. The proportions of women testing positive for HR-HPV without cytological abnormalities, whose early recall HR-HPV tests returned negative results, were similar across the age spans: 54% at 24–29 years and 55% at 50–64 years. Two-thirds of infections at any age were linked to non-16/18 genotypes. Among women with CIN2, CIN3 or cervical cancer, however, the proportion of non-16/18 infections increased with age. As expected, the detection of abnormalities was lower following screening with LBC.
Conclusions
These data provide a reliable reference for future epidemiological studies, including those concerning the effectiveness of HPV vaccination.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2021 The Authors. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited (http://creativecommons.org/licenses/by/4.0/). |
Keywords: | Cervical cancer; human papillomavirus; outcomes; screening |
Dates: |
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Institution: | The University of Sheffield |
Academic Units: | The University of Sheffield > Sheffield Teaching Hospitals |
Depositing User: | Symplectic Sheffield |
Date Deposited: | 03 Mar 2022 13:03 |
Last Modified: | 09 Dec 2022 14:36 |
Status: | Published |
Publisher: | Wiley |
Refereed: | Yes |
Identification Number: | 10.1111/1471-0528.17058 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:184323 |