PRIMARY HPV TESTING AS AN ALTERNATIVE STRATEGY FOR CERVICAL CANCER SCREENING
DOI:
https://doi.org/10.52340/jecm.2023.03.05Keywords:
Cervical cancer screening, HPV test, CytologyAbstract
Cervical cytology has been considered a reliable test for the detection of precancerous lesions and cancer for decades. Cytology-based screening has been considered a reliable test for the detection of cervical precancerous lesions and cancer for decades. Over the past decade, several randomized trials have shown HPV tests as a test with higher sensitivity and accuracy in the diagnosis of cervical lesions. The latest European and US guidelines call for screening using an HPV test that would allow us to be more accurate in the detection of cervical precancer and cancer, as well as increase the screening interval in case of a negative result. The study aimed to compare the advantages and disadvantages of cytology and HPV-based screening. Data were obtained from peer-reviewed literature, national recommendations, and practice guidelines. According to the mentioned literature review, it was determined that the positive achievements of HPV primary screening, compared to cytological screening, can be considered: higher sensitivity to detect cervical squamous and glandular precancerous lesions, and finally reduction in cervical cancer incidence. The potential harm of primary HPV screening includes increased positive test results, referral to colposcopy, and the number of biopsies, as well as excessive detection of non-progressive CIN2+ lesions. These risks are especially pronounced in young women. The potential harm of HPV primary screening can be significantly reduced or avoided by implementing an appropriate screening policy adjusting the age range, and using cytological triage.
Downloads
References
Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, Bray F. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021 May;71(3):209-249.
Sankaranarayanan, R., Nene, B. M., Shastri, S. S., Jayant, K., Muwonge, R., & Malvi, S. G. (2011). Reply to SD Rathod’s Commentary on HPV screening for cervical cancer in rural India.
Canfell K. Towards the global elimination of cervical cancer. Papillomavirus Res. 2019 Dec;8:100170.
Zhang S, Batur P. Human papillomavirus in 2019: An update on cervical cancer prevention and screening guidelines. Cleve Clin J Med. 2019 Mar;86(3):173-178.
Bouvard V, Wentzensen N, Mackie A, et al. The IARC Perspective on Cervical Cancer Screening. N Engl J Med. 2021 Nov 11;385(20):1908-1918.
Bedell, S. L., Goldstein, L. S., Goldstein, A. R., et al. Cervical cancer screening: past, present, and future. Sexual medicine reviews, 2020; 8(1):28-37.
Ronco, G., Dillner, J., et al. Efficacy of HPV-based screening for prevention of invasive cervical cancer: follow-up of four European randomized controlled trials. The lancet, 2014; 383(9916): 524-532.
Arrossi, S., Thouyaret, L., Herrero, R., et al. Effect of self-collection of HPV DNA offered by community health workers at home visits on uptake of screening for cervical cancer (the EMA study): a population-based cluster-randomized trial. The Lancet Global Health, 2015; 3(2):e85-e94.
Verdoodt, F., Jentschke, M., Hillemanns, P., et al. Reaching women who do not participate in the regular cervical cancer screening program by offering self-sampling kits: a systematic review and meta-analysis of randomized trials. European journal of cancer, 2015; 51(16), 2375-2385.
Perehudoff, K., Vermandere, H., Williams, A., et al. Universal cervical cancer control through a right to health lens: refocusing national policy and programs on underserved women. BMC international health and human rights, 2020; 20: 1-9
Lorenzi, A. T., Fregnani, J. H. T., Dockter, J., et al. High-risk human papillomavirus detection in urine samples from a referral population with cervical biopsy-proven high-grade lesions. Journal of lower genital tract disease, 2018; 22(1), 17-20.
Wright Jr, T. C., Stoler, M. H., et al. The ATHENA human papillomavirus study: design, methods, and baseline results. American journal of obstetrics and gynecology, 2012; 206(1), 46.e1-46.e11.
Rijkaart, D. C., Berkhof, J., Rozendaal, L., et al. Human papillomavirus testing for the detection of high-grade cervical intraepithelial neoplasia and cancer: final results of the POBASCAM randomized controlled trial. The lancet oncology, 2012; 13(1): 78-88.
Leinonen, M. K., Nieminen, P., Lönnberg, S., et al. Detection rates of precancerous and cancerous cervical lesions within one screening round of primary human papillomavirus DNA testing: prospective randomized trial in Finland. Bmj, 2012; 345:e7789.
Kang, M., Ha, S. Y., Cho, H. Y., et al. Comparison of Papanicolaou smear and human papillomavirus (HPV) test as cervical screening tools: can we rely on HPV test alone as a screening method? An 11-year retrospective experience at a single institution. Journal of Pathology and Translational Medicine, 2020; 54(1):112-118.
Ge, Y., Mody, R. R., Olsen, R. J., et al. HPV status in women with high-grade dysplasia on cervical biopsy and preceding negative HPV tests. Journal of the American Society of Cytopathology, 2019; 8(3): 149-156.
Blatt, A. J., Kennedy, R., Luff, R. D., et al. Comparison of cervical cancer screening results among 256,648 women in multiple clinical practices. Cancer cytopathology, 2015; 123(5): 282-288.
Zhao, C., Li, Z., Nayar, R., et al. Prior high-risk human papillomavirus testing and Papanicolaou test results of 70 invasive cervical carcinomas diagnosed in 2012: results of a retrospective multicenter study. Archives of Pathology and Laboratory Medicine, 2015; 139(2):184-188.
Moscicki, A. B., Shiboski, S., Hills, N. K., et al. Regression of low-grade squamous intra-epithelial lesions in young women. The Lancet, 2004; 364(9446):1678-1683.
Chen, E. Y., Tran, A., Raho, C. J., et al. Histological ‘progression’ from low (LSIL) to high (HSIL) squamous intraepithelial lesion is an uncommon event and an indication for quality assurance review. Modern Pathology, 2010; 23(8):1045-1051.
Darragh TM, Colgan TJ, Cox JT, et al. The Lower Anogenital Squamous Terminology Standardization Project for HPV-Associated Lesions: background and consensus recommendations from the College of American Pathologists and the American Society for Colposcopy and Cervical Pathology. J Low Genit Tract Dis. 2012 Jul;16(3):205-42.
Woodman, C. B., Collins, S., Winter, H., et al. history of cervical human papillomavirus infection in young women: a longitudinal cohort study. The Lancet, 2001; 357(9271): 1831-1836.
Bruno, M. T., Ferrara, M., Fava, V., et al. HPV genotype determination and E6/E7 mRNA detection for management of HPV positive women. Virology journal, 2018; 15:1-5.
Smith, J. S., Lindsay, L., Hoots, B., et al. Human papillomavirus type distribution in invasive cervical cancer and high‐grade cervical lesions: a meta‐analysis update. International journal of cancer, 2007; 121(3): 621-632.
Clifford, G. M., Smith, J. S., Aguado, T., et al. Comparison of HPV type distribution in high-grade cervical lesions and cervical cancer: a meta-analysis. British journal of cancer, 2003; 89(1): 101-105.
Gustafsson, L., Pontén, J., Zack, M., et al. International incidence rates of invasive cervical cancer after introduction of cytological screening. Cancer causes & control, 1997; 8:755-763.
Vizcaino, A. P., Moreno, V., Bosch, F. X., et al. International trends in incidence of cervical cancer: II. Squamous‐cell carcinoma. International journal of cancer, 2000; 86(3):429-435.
Bray, F., Carstensen, B., Møller, H., et al. Incidence trends of adenocarcinoma of the cervix in 13 European countries. Cancer Epidemiology Biomarkers & Prevention, 2005; 14(9):2191-99.
Wilbur, D. C., Chhieng, D. C., Guidos, B., et al. Epithelial abnormalities: glandular. The Bethesda System for Reporting Cervical Cytology: Definitions, Criteria, and Explanatory Notes, 2015; 193-240.
Bansal B, Gupta P, Gupta N, Rajwanshi A, Suri V. Detecting uterine glandular lesions: Role of cervical cytology. Cytojournal. 2016 Feb 22;13:3.
Costa, S., Negri, G., Sideri, M., et al. Human papillomavirus (HPV) test and PAP smear as predictors of outcome in conservatively treated adenocarcinoma in situ (AIS) of the uterine cervix. Gynecologic oncology, 2007; 106(1):170-176.
Kumar, N., Gupta, R., Gupta, S. Glandular cell abnormalities in cervical cytology: What has changed in this decade and what has not? European Journal of Obstetrics & Gynecology and Reproductive Biology, 2019; 240: 68-73.
Castanon, A., Landy, R., Sasieni, P. D. Is cervical screening preventing adenocarcinoma and adenosquamous carcinoma of the cervix? International journal of cancer, 2016; 139(5):1040-1045.
Miller, R. A., Mody, D. R., Tams, K. C., et al. Glandular lesions of the cervix in clinical practice: a cytology, histology, and human papillomavirus correlation study from 2 institutions. Archives of Pathology & Laboratory Medicine, 2015; 139(11):1431-1436.
Schiffman, M., Doorbar, J., Wentzensen, N., et al. Carcinogenic human papillomavirus infection. Nature reviews Disease primers. 2016; 2: 16086.
Arbyn M, Smith SB, Temin S, Sultana F, Castle P; Collaboration on Self-Sampling and HPV Testing. Detecting cervical precancer and reaching underscreened women by using HPV testing on self samples: updated meta-analyses. BMJ. 2018 Dec 5;363:k4823.
Sharp L, Cotton S, Cochran C, Gray N, Little J, Neal K, Cruickshank M. After-effects reported by women following colposcopy, cervical biopsies and LLETZ: results from the TOMBOLA trial. BJOG. 2009 Oct;116(11):1506-14.
Stuart GC, Kitchener H, Bacon M, duBois A, Friedlander M, Ledermann J, Marth C, Thigpen T, Trimble E; 2010 Gynecologic Cancer InterGroup (GCIG) consensus statement on clinical trials in ovarian cancer: report from the Fourth Ovarian Cancer Consensus Conference. Int J Gynecol Cancer. 2011 May;21(4):750-5.
Bao, H., Ma, L., Zhao, Y., Song, B., et al. Age‐specific effectiveness of primary human papillomavirus screening versus cytology in a cervical cancer screening program: a nationwide cross‐sectional study. Cancer Communications, 2022; 42(3):191-204.
Katki, H. A., Schiffman, M., Castle, P. E., et al. Five-year risks of CIN 3+ and cervical cancer among women with HPV testing of ASC-US Pap results. Journal of lower genital tract disease, 2013; 17: S36-S42.
Dillner J, Rebolj M, Birembaut P, et al. Long term predictive values of cytology and human papillomavirus testing in cervical cancer screening: joint European cohort study. BMJ. 2008 Oct 13;337:a1754.
Buskwofie, A., David-West, G., Clare, C. A. A review of cervical cancer: incidence and disparities. Journal of the National Medical Association, 2020; 112(2), 229-232.
MacLaughlin, K. L., Jacobson, R. M., Radecki Breitkopf, C., et al. Trends over time in Pap and Pap-HPV cotesting for cervical cancer screening. Journal of women's health, 2019; 28(2), 244-249.
Johnson, N. L., Head, K. J., Scott, S. F., Zimet, G. D. Persistent disparities in cervical cancer screening uptake: knowledge and sociodemographic determinants of Papanicolaou and human papillomavirus testing among women in the United States. Public Health Reports, 2020; 135(4):483-491.
Poljak, M., Seme, K., Maver, P. J., et al. Human papillomavirus prevalence and type-distribution, cervical cancer screening practices and current status of vaccination implementation in Central and Eastern Europe. Vaccine, 2013; 31: H59-H70.
Ryzhov, A., Corbex, M., Piñeros, M., et al. Comparison of breast cancer and cervical cancer stage distributions in ten newly independent states of the former Soviet Union: a population-based study. The Lancet Oncology, 2021; 22(3):361-369.
Downloads
Published
How to Cite
Issue
Section
