Limits...
The Clinical Role of HPV Testing in Primary and Secondary Cervical Cancer Screening.

Hoste G, Vossaert K, Poppe WA - Obstet Gynecol Int (2013)

Bottom Line: Nevertheless limitations remain and new screening methods are emerging.The sensitivity of HPV testing in primary and secondary prevention outweighs that of cytology, at the cost of slightly lower specificity.An HR-HPV test 6 months after conization is a promising useful clinical marker to detect persistence and prevent progression.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynaecology, University Hospitals Leuven (Campus Gasthuisberg), Herestraat 49, 3000 Leuven, Belgium.

ABSTRACT
Traditional population-based cervical screening programs, based on cytology, have successfully reduced the burden of cervical cancer. Nevertheless limitations remain and new screening methods are emerging. Despite vaccination against the 2 most oncogenic types (HPV 16/18), cervical cancer screening will have to continue as an essential public health strategy. As the acquisition of an HR-HPV infection is critical in the progression to (pre-)cancerous cervical lesions, recent research has focused on HR-HPV detection. The sensitivity of HPV testing in primary and secondary prevention outweighs that of cytology, at the cost of slightly lower specificity. Although most of the HR-HPV infections are cleared after conization, new evidence from numerous studies encourages the implementation of HR-HPV testing and genotyping to improve posttreatment surveillance. An HR-HPV test 6 months after conization is a promising useful clinical marker to detect persistence and prevent progression. This review highlights the clinical role of HPV testing in primary and secondary cervical cancer screening.

No MeSH data available.


Related in: MedlinePlus

Meta-analysis of the sensitivity and specificity, including pooled estimates of testing 6 months after treatment with cytology, HR-HPV, or cotesting. Legend: forest plots of sensitivity (left) and specificity (right). TP = true positives, FP = false positives, FN = false negatives, TN = true negatives, FEM = fixed effect model, REM = random effects model, DOR = diagnostic odds ratio [16–21].
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Related In: Results  -  Collection


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fig3: Meta-analysis of the sensitivity and specificity, including pooled estimates of testing 6 months after treatment with cytology, HR-HPV, or cotesting. Legend: forest plots of sensitivity (left) and specificity (right). TP = true positives, FP = false positives, FN = false negatives, TN = true negatives, FEM = fixed effect model, REM = random effects model, DOR = diagnostic odds ratio [16–21].

Mentions: In a recent meta-analysis, Kocken et al. described the value of testing for cytology and/or HR-HPV in the surveillance of women treated by conization for CIN2+ [16]. At the 6-month posttreatment examination, HR-HPV testing has a significantly higher sensitivity than cytology, indicated by a relative sensitivity of 1.15 (95% CI 1.06–1.25), without decreasing the specificity (relative specificity 0.95, 0.88–1.02). Combined analysis of cytology and HR-HPV test predicted high-grade disease recurrence with higher sensitivity than the separate individual tests (Figures 3 and 4) [16–22].


The Clinical Role of HPV Testing in Primary and Secondary Cervical Cancer Screening.

Hoste G, Vossaert K, Poppe WA - Obstet Gynecol Int (2013)

Meta-analysis of the sensitivity and specificity, including pooled estimates of testing 6 months after treatment with cytology, HR-HPV, or cotesting. Legend: forest plots of sensitivity (left) and specificity (right). TP = true positives, FP = false positives, FN = false negatives, TN = true negatives, FEM = fixed effect model, REM = random effects model, DOR = diagnostic odds ratio [16–21].
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3713364&req=5

fig3: Meta-analysis of the sensitivity and specificity, including pooled estimates of testing 6 months after treatment with cytology, HR-HPV, or cotesting. Legend: forest plots of sensitivity (left) and specificity (right). TP = true positives, FP = false positives, FN = false negatives, TN = true negatives, FEM = fixed effect model, REM = random effects model, DOR = diagnostic odds ratio [16–21].
Mentions: In a recent meta-analysis, Kocken et al. described the value of testing for cytology and/or HR-HPV in the surveillance of women treated by conization for CIN2+ [16]. At the 6-month posttreatment examination, HR-HPV testing has a significantly higher sensitivity than cytology, indicated by a relative sensitivity of 1.15 (95% CI 1.06–1.25), without decreasing the specificity (relative specificity 0.95, 0.88–1.02). Combined analysis of cytology and HR-HPV test predicted high-grade disease recurrence with higher sensitivity than the separate individual tests (Figures 3 and 4) [16–22].

Bottom Line: Nevertheless limitations remain and new screening methods are emerging.The sensitivity of HPV testing in primary and secondary prevention outweighs that of cytology, at the cost of slightly lower specificity.An HR-HPV test 6 months after conization is a promising useful clinical marker to detect persistence and prevent progression.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynaecology, University Hospitals Leuven (Campus Gasthuisberg), Herestraat 49, 3000 Leuven, Belgium.

ABSTRACT
Traditional population-based cervical screening programs, based on cytology, have successfully reduced the burden of cervical cancer. Nevertheless limitations remain and new screening methods are emerging. Despite vaccination against the 2 most oncogenic types (HPV 16/18), cervical cancer screening will have to continue as an essential public health strategy. As the acquisition of an HR-HPV infection is critical in the progression to (pre-)cancerous cervical lesions, recent research has focused on HR-HPV detection. The sensitivity of HPV testing in primary and secondary prevention outweighs that of cytology, at the cost of slightly lower specificity. Although most of the HR-HPV infections are cleared after conization, new evidence from numerous studies encourages the implementation of HR-HPV testing and genotyping to improve posttreatment surveillance. An HR-HPV test 6 months after conization is a promising useful clinical marker to detect persistence and prevent progression. This review highlights the clinical role of HPV testing in primary and secondary cervical cancer screening.

No MeSH data available.


Related in: MedlinePlus