HPV DNA testing with cytology triage in cervical cancer screening: Influence of revealing HPV infection status
Autor(a) principal: | |
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Data de Publicação: | 2015 |
Outros Autores: | , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | http://hdl.handle.net/1822/40471 |
Resumo: | BACKGROUND: Knowledge of cervical human papillomavirus (HPV) status might influence a cytotechnician's assessment of cellular abnormalities. The authors compared original cytotechnicians' Papanicolaou (Pap) readings for which HPV status was concealed with Pap rereads for which HPV status was revealed separately for 3 screening populations. METHODS: Previously collected cervical Pap smears and clinical data were obtained from the Canadian Cervical Cancer Screening Trial (study A), the Democratic Republic of Congo Community-Based Screening Study (study B), and the Brazilian Investigation into Nutrition and Cervical Cancer Prevention (study C). Smears were reread with knowledge of HPV status for all HPV-positive women as well as a sample of HPV-negative women. Diagnostic performance of Pap cytology was compared between original readings and rereads. RESULTS: A total of 1767 Pap tests were reread. Among 915 rereads for HPV-positive women, the contrast between "revealed" and "concealed" Pap readings demonstrated revisions from negative to positive results for 109 women (cutoff was atypical squamous cells of undetermined significance or worse) and 124 women (cutoff was low-grade squamous intraepithelial lesions [LSIL] or worse). For a disease threshold of cervical intraepithelial neoplasia of grade 2 or worse, specificity significantly declined at the atypical squamous cells of undetermined significance cutoff for studies A (86.6% to 75.3%) and C (42.5% to 15.5%), and at the LSIL cutoff for study C (61.9% to 37.6%). Sensitivity remained nearly unchanged between readings, except in study C, in which reread performance was superior (91.3% vs 71.9% for the LSIL cutoff). CONCLUSIONS: A reduction in the diagnostic accuracy of Pap cytology was observed when revealing patients' cervical HPV status, possibly due to a heightened awareness of potential abnormalities, which led to more false-positive results. Cancer (Cancer Cytopathol) 2015. (c) 2015 American Cancer Society. |
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HPV DNA testing with cytology triage in cervical cancer screening: Influence of revealing HPV infection statusCervical cancerHuman papillomavirus (HPV)Papanicolaou testScreeningCiências Médicas::Medicina BásicaScience & TechnologyBACKGROUND: Knowledge of cervical human papillomavirus (HPV) status might influence a cytotechnician's assessment of cellular abnormalities. The authors compared original cytotechnicians' Papanicolaou (Pap) readings for which HPV status was concealed with Pap rereads for which HPV status was revealed separately for 3 screening populations. METHODS: Previously collected cervical Pap smears and clinical data were obtained from the Canadian Cervical Cancer Screening Trial (study A), the Democratic Republic of Congo Community-Based Screening Study (study B), and the Brazilian Investigation into Nutrition and Cervical Cancer Prevention (study C). Smears were reread with knowledge of HPV status for all HPV-positive women as well as a sample of HPV-negative women. Diagnostic performance of Pap cytology was compared between original readings and rereads. RESULTS: A total of 1767 Pap tests were reread. Among 915 rereads for HPV-positive women, the contrast between "revealed" and "concealed" Pap readings demonstrated revisions from negative to positive results for 109 women (cutoff was atypical squamous cells of undetermined significance or worse) and 124 women (cutoff was low-grade squamous intraepithelial lesions [LSIL] or worse). For a disease threshold of cervical intraepithelial neoplasia of grade 2 or worse, specificity significantly declined at the atypical squamous cells of undetermined significance cutoff for studies A (86.6% to 75.3%) and C (42.5% to 15.5%), and at the LSIL cutoff for study C (61.9% to 37.6%). Sensitivity remained nearly unchanged between readings, except in study C, in which reread performance was superior (91.3% vs 71.9% for the LSIL cutoff). CONCLUSIONS: A reduction in the diagnostic accuracy of Pap cytology was observed when revealing patients' cervical HPV status, possibly due to a heightened awareness of potential abnormalities, which led to more false-positive results. Cancer (Cancer Cytopathol) 2015. (c) 2015 American Cancer Society.Financial support for the Canadian Cervical Cancer Screening Trial was provided by the Canadian Institutes of Health Research (CIHR) (grant MCT-54063 to Dr. Franco). The Democratic Republic of Congo's Cervical Screening Study was funded by the Program for Appropriate Technology in Health (grant to Dr. Sangwa-Lugoma). The Brazilian Investigation into Nutrition and Cervical Cancer Prevention study received funding from the Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (grant to Dr. Cardoso). Additional support for the work performed in rereading Papanicolaou tests was provided by a CIHR team grant (83320 to Dr. Franco). Additional support for human papillomavirus testing and genotyping was provided by the above CIHR team grant and the Reseau FRQS SIDA-MI.WileyUniversidade do MinhoRichardson, Lyndsay AnnEl-Zein, MariamRamanakumar, Agnihotram V.Ratnam, SamuelSangwa-Lugoma, GhislainLongatto Filho, AdhemarCardoso, Marly AugustoCoutlee, FrancoisFranco, Eduardo L.The PEACHS (Pap Efficacy After Cervical HPV Status) Study Consortium2015-122015-12-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/1822/40471engRichardson, L. A., El-Zein, M., Ramanakumar, A. V., Ratnam, S., Sangwa-Lugoma, G., Longatto-Filho, A., . . . S, P. P. E. C. H. (2015). HPV DNA testing with cytology triage in cervical cancer screening: Influence of revealing HPV infection status. Cancer Cytopathology, 123(12), 745-754.1934-662X10.1002/cncy.2159626230283http://onlinelibrary.wiley.com/doi/10.1002/cncy.21596/fullinfo:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-07-21T12:03:59Zoai:repositorium.sdum.uminho.pt:1822/40471Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T18:54:10.267737Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
HPV DNA testing with cytology triage in cervical cancer screening: Influence of revealing HPV infection status |
title |
HPV DNA testing with cytology triage in cervical cancer screening: Influence of revealing HPV infection status |
spellingShingle |
HPV DNA testing with cytology triage in cervical cancer screening: Influence of revealing HPV infection status Richardson, Lyndsay Ann Cervical cancer Human papillomavirus (HPV) Papanicolaou test Screening Ciências Médicas::Medicina Básica Science & Technology |
title_short |
HPV DNA testing with cytology triage in cervical cancer screening: Influence of revealing HPV infection status |
title_full |
HPV DNA testing with cytology triage in cervical cancer screening: Influence of revealing HPV infection status |
title_fullStr |
HPV DNA testing with cytology triage in cervical cancer screening: Influence of revealing HPV infection status |
title_full_unstemmed |
HPV DNA testing with cytology triage in cervical cancer screening: Influence of revealing HPV infection status |
title_sort |
HPV DNA testing with cytology triage in cervical cancer screening: Influence of revealing HPV infection status |
author |
Richardson, Lyndsay Ann |
author_facet |
Richardson, Lyndsay Ann El-Zein, Mariam Ramanakumar, Agnihotram V. Ratnam, Samuel Sangwa-Lugoma, Ghislain Longatto Filho, Adhemar Cardoso, Marly Augusto Coutlee, Francois Franco, Eduardo L. The PEACHS (Pap Efficacy After Cervical HPV Status) Study Consortium |
author_role |
author |
author2 |
El-Zein, Mariam Ramanakumar, Agnihotram V. Ratnam, Samuel Sangwa-Lugoma, Ghislain Longatto Filho, Adhemar Cardoso, Marly Augusto Coutlee, Francois Franco, Eduardo L. The PEACHS (Pap Efficacy After Cervical HPV Status) Study Consortium |
author2_role |
author author author author author author author author author |
dc.contributor.none.fl_str_mv |
Universidade do Minho |
dc.contributor.author.fl_str_mv |
Richardson, Lyndsay Ann El-Zein, Mariam Ramanakumar, Agnihotram V. Ratnam, Samuel Sangwa-Lugoma, Ghislain Longatto Filho, Adhemar Cardoso, Marly Augusto Coutlee, Francois Franco, Eduardo L. The PEACHS (Pap Efficacy After Cervical HPV Status) Study Consortium |
dc.subject.por.fl_str_mv |
Cervical cancer Human papillomavirus (HPV) Papanicolaou test Screening Ciências Médicas::Medicina Básica Science & Technology |
topic |
Cervical cancer Human papillomavirus (HPV) Papanicolaou test Screening Ciências Médicas::Medicina Básica Science & Technology |
description |
BACKGROUND: Knowledge of cervical human papillomavirus (HPV) status might influence a cytotechnician's assessment of cellular abnormalities. The authors compared original cytotechnicians' Papanicolaou (Pap) readings for which HPV status was concealed with Pap rereads for which HPV status was revealed separately for 3 screening populations. METHODS: Previously collected cervical Pap smears and clinical data were obtained from the Canadian Cervical Cancer Screening Trial (study A), the Democratic Republic of Congo Community-Based Screening Study (study B), and the Brazilian Investigation into Nutrition and Cervical Cancer Prevention (study C). Smears were reread with knowledge of HPV status for all HPV-positive women as well as a sample of HPV-negative women. Diagnostic performance of Pap cytology was compared between original readings and rereads. RESULTS: A total of 1767 Pap tests were reread. Among 915 rereads for HPV-positive women, the contrast between "revealed" and "concealed" Pap readings demonstrated revisions from negative to positive results for 109 women (cutoff was atypical squamous cells of undetermined significance or worse) and 124 women (cutoff was low-grade squamous intraepithelial lesions [LSIL] or worse). For a disease threshold of cervical intraepithelial neoplasia of grade 2 or worse, specificity significantly declined at the atypical squamous cells of undetermined significance cutoff for studies A (86.6% to 75.3%) and C (42.5% to 15.5%), and at the LSIL cutoff for study C (61.9% to 37.6%). Sensitivity remained nearly unchanged between readings, except in study C, in which reread performance was superior (91.3% vs 71.9% for the LSIL cutoff). CONCLUSIONS: A reduction in the diagnostic accuracy of Pap cytology was observed when revealing patients' cervical HPV status, possibly due to a heightened awareness of potential abnormalities, which led to more false-positive results. Cancer (Cancer Cytopathol) 2015. (c) 2015 American Cancer Society. |
publishDate |
2015 |
dc.date.none.fl_str_mv |
2015-12 2015-12-01T00:00:00Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/1822/40471 |
url |
http://hdl.handle.net/1822/40471 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
Richardson, L. A., El-Zein, M., Ramanakumar, A. V., Ratnam, S., Sangwa-Lugoma, G., Longatto-Filho, A., . . . S, P. P. E. C. H. (2015). HPV DNA testing with cytology triage in cervical cancer screening: Influence of revealing HPV infection status. Cancer Cytopathology, 123(12), 745-754. 1934-662X 10.1002/cncy.21596 26230283 http://onlinelibrary.wiley.com/doi/10.1002/cncy.21596/full |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Wiley |
publisher.none.fl_str_mv |
Wiley |
dc.source.none.fl_str_mv |
reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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