Risk Assessment in a Chinese Cohort of 96,318 Females Undergoing Opportunistic Cervical Cancer Screening.

IF 4.8 2区医学 Q1 ONCOLOGY

Oncologist Pub Date : 2025-07-01 DOI:10.1093/oncolo/oyaf197

Jing Zhao, Wenhan Li, Zehua Wang, Weichao Liu, Si Sun, Liying Wu, Shi Du, Guoqing Li, Zhongya Pan, Dingyu Chen, Pinglan Yang, Wuliang Wang, Liqiong Cai, Bangxing Huang, Jing Cai

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引用次数: 0

Abstract

Objective: To assess CIN3+ risk in a Chinese cohort of outpatients undergoing contesting screening and to evaluate the portability of the ASCCP risk-based management, which were primarily developed using data from the KPNC cohort.

Methods: Females aged 25-65 years who were screened with cytology and high-risk human papillomavirus (hrHPV) cotesting between 2011 and 2020 at Wuhan Union Hospital (WHUH) were retrospectively studied. The risks of immediate and 3-year CIN3+ were estimated via prevalence-incidence mixture models. Portability was evaluated via the ratio of the observation risk in the WHUH cohort to the expected risk in the KPNC cohort (O/E) and its 95% confidence interval (CI).

Results: A total of 96,318 females were included, and 16·83% of the women tested hrHPV positive at initial screening, who had a CIN3+ immediate risk of 14·14%. The CIN3+ immediate risk varied between subgroups of positive HPV16 (34·09%), HPV18 (13·38%), other HPV types (6·71%), and negative hrHPV (0·12%). Compared to the KPNC cohort, our cohort exhibited a significantly higher CIN3+ immediate risk (1·42% vs. 0·46%; O/E, 3·09; 95% CI, 2·92-3·26) and disproportionately increased cancer immediate risks in most subgroups requiring immediate colposcopy or treatment, as well as higher 3-year CIN3+ risks in women with hrHPV negative ASC-US/NILM. Yet, the action threshold suggested by ASCCP, a CIN3+ immediate risk of 4%, showed good portability to our cohort.

Conclusion: Despite the higher risks in our cohort, the ASCCP clinical action threshold remains portable. For women with minimal abnormalities or normal results, shortened follow-up intervals should be considered.

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中国96318名接受机会性宫颈癌筛查的女性队列的风险评估

目的：评估接受竞争筛查的中国门诊患者的CIN3+风险，并评估基于ASCCP风险管理的可移植性，该管理主要使用来自KPNC队列的数据。方法：回顾性分析2011 - 2020年武汉协和医院细胞学筛查和高危人乳头瘤病毒（hrHPV）联合检测的25-65岁女性。通过患病率-发病率混合模型估计即时和3年CIN3+的风险。通过WHUH队列的观察风险与KPNC队列的预期风险之比（O/E）及其95%置信区间（CI）来评估可移植性。结果：共纳入96,318名女性，在初始筛查时hrHPV阳性的女性中有16.83%，CIN3+即时风险为14.14%。HPV16阳性亚组（34.09%）、HPV18阳性亚组（13.38%）、其他HPV亚型（6.71%）和hrHPV阴性亚组（0.12%）之间的CIN3+即时风险存在差异。与KPNC队列相比，我们的队列显示出明显更高的CIN3+即时风险(1.42% vs. 0.46%；O / E, 3·09年;95% CI, 2.92 - 3.26)，并且在大多数需要立即阴道镜检查或治疗的亚组中不成比例地增加了癌症即时风险，并且hrHPV阴性ASC-US/NILM妇女的3年CIN3+风险更高。然而，ASCCP建议的动作阈值（CIN3+即刻风险为4%）对我们的队列显示了良好的可移植性。结论：尽管在我们的队列中风险较高，但ASCCP的临床作用阈值仍然是可移植的。对于有轻微异常或正常结果的妇女，应考虑缩短随访间隔。

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

Oncologist 医学-肿瘤学

CiteScore

10.40

自引率

3.40%

发文量

309

审稿时长

3-8 weeks

期刊介绍： The Oncologist® is dedicated to translating the latest research developments into the best multidimensional care for cancer patients. Thus, The Oncologist is committed to helping physicians excel in this ever-expanding environment through the publication of timely reviews, original studies, and commentaries on important developments. We believe that the practice of oncology requires both an understanding of a range of disciplines encompassing basic science related to cancer, translational research, and clinical practice, but also the socioeconomic and psychosocial factors that determine access to care and quality of life and function following cancer treatment.