Comparison of cervical cancer screening models based on Pap and HPV tests in Tbilisi, Georgia.

IF 1.1 4区 医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Eter Kiguradze, Tamar Skhirtladze, Nikoloz Chkhartishvili, Tamuna Gogoladze, Nino Chikhladze, Tamar Alibegashvili
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引用次数: 0

Abstract

Objective: The objective of this study was to evaluate the effectiveness of human papillomavirus HPV test with HPV16/18 genotyping and liquid-based cytology (LBC) triage as a primary screening method for cervical cancer compared to conventional Pap test in women undergoing routine cervical cancer screening in Tbilisi.

Methods: Cross-sectional, prospective study was conducted, where 1,000 enrolled women aged 30-60 years during one visit underwent conventional Pap smear and Hr-HPV testing (Roche Cobas system). Women with any positive screening results were referred for further evaluation and remaining cells from the Cell Collection Medium vial were used for LBC. The study calculated sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for each screening method and receiver-operating characteristic (ROC) curve to evaluate the accuracy of each diagnostic method in identifying people with CIN2+ diseases.

Results: The HPV test with HPV16/18 genotyping and LBC triage demonstrated higher sensitivity (76.9%), specificity (71.6%), and PPV (34.5%) compared to conventional Pap tests (p < 0.05). NPV was also high with the HPV test (94.1%). The HPV test alone had the highest sensitivity (92.3%) and NPV (96.7%), but lower specificity (41.4%) and PPV (22.6%) than the HPV test with HPV16/18 genotyping and LBC triage (p < 0.05). Comparing the areas under the curve (AUCs), only the HPV with HPV16/18 genotyping and LBC triage showed a statistically significant difference when compared to conventional Pap (0.71 vs. 0.55, p = 0.03) and high figures of AUC 0.71 (95% CI: 0.58-0.85) suggesting that HPV test with HPV16/18 genotyping and LBC triage is a more reliable screening method for detecting CIN2+ disease and preventing cervical cancer, than other screening modality.

Conclusion: The results suggest that the HPV test with HPV16/18 genotyping and LBC triage is a more effective primary screening method compared to conventional Pap tests. This information should be the basis for transition from cytological screening to HPV testing in Georgia.

格鲁吉亚第比利斯基于巴氏试验和 HPV 试验的宫颈癌筛查模式比较。
研究目的本研究的目的是评估在第比利斯接受常规宫颈癌筛查的妇女中,与传统巴氏涂片检查相比,采用人乳头瘤病毒 HPV 检测(HPV16/18 基因分型)和液基细胞学(LBC)分诊作为宫颈癌初筛方法的有效性:进行了横断面前瞻性研究,对 1000 名 30-60 岁的妇女进行了一次常规巴氏涂片和 Hr-HPV 检测(罗氏 Cobas 系统)。筛查结果呈阳性的妇女将被转诊接受进一步评估,细胞采集培养基瓶中的剩余细胞将用于 LBC。研究计算了每种筛查方法的敏感性、特异性、阳性预测值(PPV)和阴性预测值(NPV),并绘制了接收者操作特征曲线(ROC),以评估每种诊断方法在识别 CIN2+ 疾病患者方面的准确性:与传统的巴氏试验相比,HPV16/18 基因分型和 LBC 分流试验的灵敏度(76.9%)、特异性(71.6%)和 PPV(34.5%)均较高(P < 0.05)。HPV 检测的 NPV 也很高(94.1%)。单用HPV检测的灵敏度(92.3%)和NPV(96.7%)最高,但特异性(41.4%)和PPV(22.6%)低于HPV16/18基因分型和LBC分流的HPV检测(p < 0.05)。比较曲线下面积(AUC),只有HPV16/18基因分型和LBC分流的HPV检测与传统巴氏涂片相比有显著的统计学差异(0.71 vs. 0.55, p = 0.03),AUC为0.71 (95% CI: 0.58-0.85),表明HPV16/18基因分型和LBC分流的HPV检测是一种比其他筛查方法更可靠的检测CIN2+疾病和预防宫颈癌的筛查方法:结果表明,与传统的巴氏试验相比,HPV16/18 基因分型和 LBC 分流试验是一种更有效的初级筛查方法。这些信息应作为格鲁吉亚从细胞学筛查过渡到 HPV 检测的依据。
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
Central European journal of public health
Central European journal of public health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
CiteScore
1.90
自引率
0.00%
发文量
45
期刊介绍: The Journal publishes original articles on disease prevention and health protection, environmental impacts on health, the role of nutrition in health promotion, results of population health studies and critiques of specific health issues including intervention measures such as vaccination and its effectiveness. The review articles are targeted at providing up-to-date information in the sphere of public health. The Journal is geographically targeted at the European region but will accept specialised articles from foreign sources that contribute to public health issues also applicable to the European cultural milieu.
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