1. Prevalence of positive screening test results and agreement between cytology and human papillomavirus testing in primary cervical cancer screening in North-Western Romania.
- Author
-
Şuteu O, Blaga ML, Nygård M, Leinonen MK, Nicula F, Păiş R, Coza D, Cadariu PA, Melnic A, Andreassen T, Hashim D, and Weiderpass E
- Subjects
- Adult, Alphapapillomavirus genetics, Alphapapillomavirus isolation & purification, Cervix Uteri cytology, Cervix Uteri pathology, Cervix Uteri virology, Cross-Sectional Studies, DNA, Viral isolation & purification, Early Detection of Cancer methods, Feasibility Studies, Female, Humans, Mass Screening methods, Middle Aged, Molecular Diagnostic Techniques statistics & numerical data, Papanicolaou Test statistics & numerical data, Papillomavirus Infections diagnosis, Papillomavirus Infections pathology, Papillomavirus Infections virology, Pilot Projects, Prevalence, Romania epidemiology, Uterine Cervical Neoplasms diagnosis, Uterine Cervical Neoplasms pathology, Uterine Cervical Neoplasms virology, Vaginal Smears statistics & numerical data, Uterine Cervical Dysplasia diagnosis, Uterine Cervical Dysplasia pathology, Uterine Cervical Dysplasia virology, Early Detection of Cancer statistics & numerical data, Mass Screening statistics & numerical data, Papillomavirus Infections epidemiology, Uterine Cervical Neoplasms epidemiology, Uterine Cervical Dysplasia epidemiology
- Abstract
Using data from a pilot study conducted in North-Western Romania, we aimed to estimate the prevalence of abnormal cytology and positive high-risk human papillomavirus (hr-HPV) test results in an ethnically diverse screening population and to assess the agreement between cytology and hr-HPV testing to evaluate the feasibility of integrating the latter as a primary test in the national cervical cancer screening program. The cross-sectional pilot study included Roma women, other ethnic minorities, and women in rural remote areas. Samples were taken for liquid-based cytology and hr-HPV testing (Hybrid Capture 2 DNA test) by a mobile health unit. The prevalence of positive screening results and the agreement between cytology and hr-HPV testing were estimated by κ coefficient. A total of 1019 women were included in the study. The population prevalence of positive screening results was similar for both tests (12%). The prevalence of abnormal cytology increased with increasing age, whereas the prevalence of positive hr-HPV test showed a bimodal age pattern. Substantial differences in the prevalence of abnormal cytology were found by ethnicity, with highest prevalence in Romanian women (14%), followed by Roma women (6%) and women of other ethnicities (5%) (P = 0.002). Similar ethnic differences in the prevalence of positive hr-HPV test were not observed. The overall agreement of positive screening results between the two methods was fair (κ = 0.25; 95% confidence interval = 0.18-0.30, P < 0.001) and ranged from poor to substantial depending on the age group. The prevalence of abnormal cytology result was high and similar to the prevalence of positive hr-HPV test result, which could allow for the implementation of hr-HPV testing as a primary test in the cervical cancer screening program in Romania.
- Published
- 2020
- Full Text
- View/download PDF