Primary human papillomavirus testing vs cotesting: clinical outcomes in populations with different disease prevalence.

IF 9.9 1区 医学 Q1 ONCOLOGY
Shrutikona Das, Nicolas Wentzensen, George F Sawaya, Didem Egemen, Alexander Locke, Walter Kinney, Thomas Lorey, Li C Cheung
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Abstract

Implementation of primary human papillomavirus (HPV) testing has been slow in the United States perhaps because of concerns of decreased sensitivity compared with concurrent HPV and cytology testing ("cotesting"). We used the National Breast and Cervical Cancer Early Detection Program and the Kaiser Permanente of Northern California cohort to quantify potential trade-offs with primary HPV compared with cotesting in 4 US populations with differing precancer or cancer prevalence. In all settings, cotesting required more lab tests and more colposcopies compared with primary HPV testing. Additional cervical intraepithelial neoplasia grade 3 or cancer immediately detected from cotesting vs primary HPV decreased with decreasing population-average cervical intraepithelial neoplasia grade 3 or cancer prevalence from 71 per 100 000 screened among never or rarely screened individuals in the National Breast and Cervical Cancer Early Detection Program (prevalence = 1212 per 100 000) to 4 per 100 000 screened among individuals with prior HPV-negative results in Kaiser Permanente of Northern California (prevalence = 86 per 100 000). These data suggest that cotesting confer an unfavorable benefit-to-harm ratio over primary HPV testing.

初级人类乳头瘤病毒检测与 CO 测试:不同疾病流行率人群的临床结果。
在美国,人类乳头瘤病毒(HPV)初筛检测的实施进展缓慢,这可能是因为人们担心与同时进行的 HPV 和细胞学检测(共检)相比灵敏度会降低。我们利用美国国家乳腺癌和宫颈癌早期检测计划(NBCCEDP)和北加州凯撒医疗集团(KPNC)队列,在美国四个不同癌前病变/癌症流行率的人群中,量化了初次HPV检测与同步检测的潜在权衡。在所有情况下,与初级 HPV 检测相比,联合检测需要更多的实验室检测和更多的阴道镜检查。随着人群平均 CIN3+ 患病率的降低,从 NBCCEDP 中从未/很少接受筛查的人群中每 100,000 人中有 71 人接受筛查(患病率 = 每 100,000 人中有 1,212 人),到 KPNC 中之前 HPV 阴性结果的人群中每 100,000 人中有 4 人接受筛查(患病率 = 每 100,000 人中有 86 人)。这些数据表明,与初次HPV检测相比,联合检测的益害比并不理想。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
17.00
自引率
2.90%
发文量
203
审稿时长
4-8 weeks
期刊介绍: The Journal of the National Cancer Institute is a reputable publication that undergoes a peer-review process. It is available in both print (ISSN: 0027-8874) and online (ISSN: 1460-2105) formats, with 12 issues released annually. The journal's primary aim is to disseminate innovative and important discoveries in the field of cancer research, with specific emphasis on clinical, epidemiologic, behavioral, and health outcomes studies. Authors are encouraged to submit reviews, minireviews, and commentaries. The journal ensures that submitted manuscripts undergo a rigorous and expedited review to publish scientifically and medically significant findings in a timely manner.
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