Population-based primary HPV mRNA cervical screening compared with cytology screening

Research output: Contribution to journalArticle

Abstract

Primary HPV screening for cervical cancer by HPV mRNA testing (Aptima)was implemented in January 2017, for women ≥30 through 70 years, in the Region of Skåne, Sweden. HPV positive samples underwent cytology assessment, and women with any degree of abnormal cytology were referred for colposcopy. The aim was to audit the primary HPV screening program, by comparing the cytology results to those of corresponding women (aged ≥30 through 65 years)screened with conventional cytology during 2016. Overall, HPV was detected among 7.0% (4433/63,055)of the women ≥30–70 years in the primary HPV screening program. Among a co-tested (cytology and HPV)subgroup aged 40–42 years (N = 5039), HPV was detected in 100% (28/28)of high-grade squamous intraepithelial lesions (HSIL)and atypical squamous cells of undetermined significance (ASCUS)where HSIL could not be excluded (ASC[sbnd]H)(9/9), and in 80% (4/5)of cases of atypical glandular cells (AGC). Among women ≥30–65 years, the proportion ASCUS or worse (ASCUS+)was similar with cytology (3.52% [2016])and primary HPV screening (3.70% [2017]). Only the proportion of ASC-H changed by the use of primary HPV screening, from 0.13% (2016)to 0.23% (2017)(p < 0.001). The colposcopy referral rate increased by 54% (3.70 vs 2.41%), when primary HPV screening was introduced. In conclusion, the implemented primary HPV screening approach demonstrated similar prevalence of ASCUS+ cytology as conventional screening. In addition, primary HPV screening decreased cytology assessments by 86% in our screening population of women 30 through 70 years taken into account the co-tested women.

Details

Authors
Organisations
External organisations
  • Skåne University Hospital
  • Lund University
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Cancer and Oncology
  • Public Health, Global Health, Social Medicine and Epidemiology

Keywords

  • Cervical, Cytology, HPV-mRNA, Screening
Original languageEnglish
Pages (from-to)61-66
Number of pages6
JournalPreventive Medicine
Volume124
Publication statusPublished - 2019
Publication categoryResearch
Peer-reviewedYes