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Comparison of different strategies for the triage to colposcopy of women tested high-risk HPV positive on self-collected cervicovaginal samples
- Source :
- Gynecologic oncology. 162(3)
- Publication Year :
- 2021
-
Abstract
- Objective To identify the optimal strategy for the triage of women who test high-risk (hr) HPV positive on self-collected cervicovaginal samples. Methods This is a diagnostic accuracy sub-analysis of the GRECOSELF study, which reported on HPV-DNA testing with self-sampling in Greece. More than 13,000 women, 25–60 years old, who resided in rural areas of Greece, provided a self-collected cervicovaginal sample. Samples were tested for HPV-DNA and HPV16/18 genotyping with the cobas® HPV test (Roche® Molecular Systems, Pleasanton, CA, USA). HrHPV positive women were referred for colposcopy. Prior to colposcopy a physician-collected sample was obtained for cytology. After colposcopy/biopsy, women were classified as having cervical disease or not, and treated accordingly. Results Out of 1070 hrHPV positive women, 773 were subjected to colposcopy. Seventeen triage strategies, combining HPV16/18 genotyping and cytology, were investigated. The strategy referring to colposcopy women positive for HPV16 regardless of the cytology report, and women positive for other hrHPVs, in case of a subsequent atypical squamous cells of undetermined significance or worse (ASCUS+) cytology report, presented optimal trade-off; sensitivity 96.36% [(95%CI: (91.41–100.0)], positive predictive value (PPV) 27.46% [95%CI: (21.16–33.76)], and number of colposcopies required to detect one case of Cervical Intraepithelial Neoplasia grade-2 or worse (CIN2+) 3.64. Conclusions The optimal strategy for the triage to colposcopy of hrHPV positive women, detected with the cobas® HPV test on self-collected cervicovaginal samples, is referring all HPV16 positive women directly to colposcopy, and women positive for HPV18 or other hrHPVs only after an ASCUS or worse cytology report.
- Subjects :
- 0301 basic medicine
Adult
medicine.medical_specialty
Uterine Cervical Neoplasms
Cervix Uteri
Alphapapillomavirus
Cervical intraepithelial neoplasia
Specimen Handling
03 medical and health sciences
0302 clinical medicine
Cytology
Biopsy
Atypical Squamous Cells of the Cervix
Medicine
Humans
Genotyping
Colposcopy
Vaginal Smears
Human papillomavirus 16
medicine.diagnostic_test
Greece
Human papillomavirus 18
business.industry
Obstetrics
Papillomavirus Infections
Obstetrics and Gynecology
Middle Aged
medicine.disease
Uterine Cervical Dysplasia
Triage
Self Care
030104 developmental biology
Oncology
ROC Curve
High risk hpv
030220 oncology & carcinogenesis
Female
business
Ascus
Subjects
Details
- ISSN :
- 10956859
- Volume :
- 162
- Issue :
- 3
- Database :
- OpenAIRE
- Journal :
- Gynecologic oncology
- Accession number :
- edsair.doi.dedup.....e5df93d0d9c3810f231ccbb9089b7a33