Long, E., Macdonald, M.C., Parker, V.L. orcid.org/0000-0002-8748-4583 et al. (3 more authors) (2023) Factors associated with failed ‘test of cure’ in the NHS cervical screening programme: a retrospective cohort study. Gynecologic Oncology, 179. pp. 158-163. ISSN 0090-8258
Abstract
Objective: To determine predictive factors associated with failed ‘test of cure’ (TOC) in the NHS Cervical Screening Programme (NHSCSP). Methods: Retrospective cohort study of all patients treated by large loop excision of transformation zone (LLETZ) between 1st April 2014 and 1st April 2019. Those with no documented HPV genotype on referral, no TOC outcome, those having a hysterectomy, chemotherapy and/or radiotherapy were excluded from final analysis. Results: Patients referred with a singular HPV genotype of HPV 16, HPV 18, or HPV Other types (HPV O) were significantly more likely to pass TOC than those referred with multiple HPV genotypes (p < 0.0001). Those with HPV genotypes including HPV O were significantly more likely to fail TOC as compared to those with genotypes of solely HPV 16 and/or 18 (p < 0.0001). Patients aged ≥51 years were significantly more likely to fail TOC when compared to all other age groups (p < 0.0001). Conclusion: Age >51 yrs. and infection with multiple hr-HPV types were predictors of post treatment hr-HPV persistence. Knowledge of HPV genotype both at referral, and following treatment, could allow a more individualised, and patient-centred, approach to both the management and follow up of CIN. HPV genotype should be reported as standard on all cervical screening sample results. The term HPV O should not be utilised and instead actual HPV genotype should be reported. This would enable us to optimise not only future research but would also allow future monitoring of the efficacy of vaccination programmes.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2023 The Authors. Published by Elsevier Inc. This is an Open Access article distributed under the terms of the Creative Commons Attribution Licence (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
Keywords: | High-risk HPV; LLETZ; Persistence; Test of cure; Female; Humans; Uterine Cervical Neoplasms; Uterine Cervical Dysplasia; State Medicine; Retrospective Studies; Papillomavirus Infections; Early Detection of Cancer; Papillomaviridae; Genotype |
Dates: |
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Institution: | The University of Sheffield |
Academic Units: | The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > School of Medicine and Population Health |
Depositing User: | Symplectic Sheffield |
Date Deposited: | 09 Feb 2024 12:21 |
Last Modified: | 09 Feb 2024 12:21 |
Published Version: | http://dx.doi.org/10.1016/j.ygyno.2023.10.022 |
Status: | Published |
Publisher: | Elsevier BV |
Refereed: | Yes |
Identification Number: | 10.1016/j.ygyno.2023.10.022 |
Related URLs: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:208861 |