Validation of the 2019 American Society of Colposcopy and Cervical Pathology Online Cervical Cancer Screening Program via 9 Large-Cohort Data of Chinese Women.

IF 2.4 4区医学 Q2 OBSTETRICS & GYNECOLOGY

Journal of Lower Genital Tract Disease Pub Date : 2024-10-22 DOI:10.1097/LGT.0000000000000852

Wenkui Dai, Chunlei Guo, Qing Yang, Yi Zhang, Di Wu, Chun Wang, Jerome L Belinson, Changzhong Li, Hui Du, Xinfeng Qu, Ruifang Wu

{"title":"Validation of the 2019 American Society of Colposcopy and Cervical Pathology Online Cervical Cancer Screening Program via 9 Large-Cohort Data of Chinese Women.","authors":"Wenkui Dai, Chunlei Guo, Qing Yang, Yi Zhang, Di Wu, Chun Wang, Jerome L Belinson, Changzhong Li, Hui Du, Xinfeng Qu, Ruifang Wu","doi":"10.1097/LGT.0000000000000852","DOIUrl":null,"url":null,"abstract":"Objective: The aim of the study is to validate the applicability and performance of the 2019 US risk-based guideline for Chinese women.Materials and methods: We analyzed 10,055 cases with data on human papillomavirus testing, cytology, and pathologically confirmed diagnosis (analysis-set). According to the 2019 US risk-based guideline, we recorded the risk value and triage recommendations for each case. Then, we assessed the concordance of the guideline triage recommendations with pathology diagnosis for the relevant case from the real-world projects.Results: Among the analysis-set, 9,495 cases with an estimated risk value were identified as analysis cohort while the remaining 560 cases were cataloged as \"special cases.\" Among the analysis cohort, 960 and 526 cases were pathologically confirmed as cervical intraepithelial neoplasia (CIN) 2+ and CIN3+, respectively. The US risk-based guideline recommended colposcopy or more aggressive interventions (Colp+) for 86.8% (833/960) of the CIN2+ and 95.8% (504/526) of the CIN3+ cases, with 87.1% sensitivity and 82.5% specificity for CIN3+ cases (AUC = 0.926, p < .0001). The US risk-based recommended no-Colp for 98.0% (6,142/6,269) of the pathologically confirmed CIN1 or benign cases. In addition, 97.3% (545/560) of the \"special cases\" cases were recommended as Colp+.Conclusions: The 2019 US risk-based guideline works well with satisfied clinical sensitivity for CIN2+ and CIN3+ and seems applicable for cervical cancer screening in China.","PeriodicalId":50160,"journal":{"name":"Journal of Lower Genital Tract Disease","volume":null,"pages":null},"PeriodicalIF":2.4000,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Lower Genital Tract Disease","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/LGT.0000000000000852","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Objective: The aim of the study is to validate the applicability and performance of the 2019 US risk-based guideline for Chinese women.

Materials and methods: We analyzed 10,055 cases with data on human papillomavirus testing, cytology, and pathologically confirmed diagnosis (analysis-set). According to the 2019 US risk-based guideline, we recorded the risk value and triage recommendations for each case. Then, we assessed the concordance of the guideline triage recommendations with pathology diagnosis for the relevant case from the real-world projects.

Results: Among the analysis-set, 9,495 cases with an estimated risk value were identified as analysis cohort while the remaining 560 cases were cataloged as "special cases." Among the analysis cohort, 960 and 526 cases were pathologically confirmed as cervical intraepithelial neoplasia (CIN) 2+ and CIN3+, respectively. The US risk-based guideline recommended colposcopy or more aggressive interventions (Colp+) for 86.8% (833/960) of the CIN2+ and 95.8% (504/526) of the CIN3+ cases, with 87.1% sensitivity and 82.5% specificity for CIN3+ cases (AUC = 0.926, p < .0001). The US risk-based recommended no-Colp for 98.0% (6,142/6,269) of the pathologically confirmed CIN1 or benign cases. In addition, 97.3% (545/560) of the "special cases" cases were recommended as Colp+.

Conclusions: The 2019 US risk-based guideline works well with satisfied clinical sensitivity for CIN2+ and CIN3+ and seems applicable for cervical cancer screening in China.

查看原文本刊更多论文

通过 9 个中国妇女大队列数据验证 2019 年美国阴道镜和宫颈病理学会在线宫颈癌筛查计划。

研究目的本研究旨在验证2019年美国基于风险的指南对中国女性的适用性和性能：我们分析了10055例病例的人乳头瘤病毒检测、细胞学和病理确诊数据（分析集）。根据 2019 年美国基于风险的指南，我们记录了每个病例的风险值和分诊建议。然后，我们评估了指南分流建议与真实世界项目中相关病例病理诊断的一致性：结果：在分析组中，9495 个具有估计风险值的病例被确定为分析组群，其余 560 个病例被列为 "特殊病例"。在分析队列中，分别有 960 例和 526 例病理证实为宫颈上皮内瘤变（CIN）2+ 和 CIN3+。美国基于风险的指南建议对86.8%的CIN2+病例（833/960）和95.8%的CIN3+病例（504/526）进行阴道镜检查或更积极的干预（Colp+），对CIN3+病例的敏感性为87.1%，特异性为82.5%（AUC = 0.926，p < .0001）。在病理确诊的 CIN1 或良性病例中，98.0%（6,142/6,269）的病例根据美国的风险建议不做结肠镜检查。此外，97.3%（545/560）的 "特殊病例 "病例被推荐为Colp+：结论：2019年美国基于风险的指南效果良好，对CIN2+和CIN3+的临床敏感性令人满意，似乎适用于中国的宫颈癌筛查。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Journal of Lower Genital Tract Disease OBSTETRICS & GYNECOLOGY-

CiteScore

6.80

自引率

8.10%

发文量

158

审稿时长

6-12 weeks

期刊介绍： The Journal of Lower Genital Tract Disease is the source for the latest science about benign and malignant conditions of the cervix, vagina, vulva, and anus. The Journal publishes peer-reviewed original research original research that addresses prevalence, causes, mechanisms, diagnosis, course, treatment, and prevention of lower genital tract disease. We publish clinical guidelines, position papers, cost-effectiveness analyses, narrative reviews, and systematic reviews, including meta-analyses. We also publish papers about research and reporting methods, opinions about controversial medical issues. Of particular note, we encourage material in any of the above mentioned categories that is related to improving patient care, avoiding medical errors, and comparative effectiveness research. We encourage publication of evidence-based guidelines, diagnostic and therapeutic algorithms, and decision aids. Original research and reviews may be sub-classified according to topic: cervix and HPV, vulva and vagina, perianal and anal, basic science, and education and learning. The scope and readership of the journal extend to several disciplines: gynecology, internal medicine, family practice, dermatology, physical therapy, pathology, sociology, psychology, anthropology, sex therapy, and pharmacology. The Journal of Lower Genital Tract Disease highlights needs for future research, and enhances health care. The Journal of Lower Genital Tract Disease is the official journal of the American Society for Colposcopy and Cervical Pathology, the International Society for the Study of Vulvovaginal Disease, and the International Federation of Cervical Pathology and Colposcopy, and sponsored by the Australian Society for Colposcopy and Cervical Pathology and the Society of Canadian Colposcopists.