Efficacy of human papillomavirus testing for the detection of invasive cervical cancers and cervical intraepithelial neoplasia: a randomised controlled trial

Ronco, Guglielmo; Rossi, Paolo Giorgi; Carozzi, Francesca; Confortini, Massimo; Palma, Paolo Dalla; Mistro, Annarosa Del; Ghiringhello, Bruno; Girlando, Salvatore; Gillio-Tos, Anna; Marco, Laura De; Naldoni, Carlo; Pierotti, Paola; Rizzolo, Raffaella; Schincaglia, Patrizia; Zorzi, Manuel; Zappa, Marco; Segnan, Nereo; Cuzick, Jack

doi:10.1016/s1470-2045(09)70360-2

Cited by 840 publications

(815 citation statements)

References 25 publications

Supporting

Mentioning

745

Contrasting

Unclassified

Order By: Relevance

“…Transmission models can capture the dynamics of infection circulation10 in a population and have the distinct advantage of including the effect of herd immunity 31. We could also derive estimates of the parameters governing the natural history of HPV16 infections from the calibration to a large screening trial conducted in Italy18 in which we were able to predict accurately the incidence of HPV16 infection in HPV16 negative women 11. This allowed us to provide a range of uncertainty for each parameter estimate 11.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Impacts of human papillomavirus vaccination for different populations: A modeling study

Baussano

Lazzarato

Ronco³

et al. 2018

Intl Journal of Cancer

Self Cite

View full text Add to dashboard Cite

International variations in the prevalence of HPV infection derive from differences in sexual behaviors, which are also a key factor of the basic reproductive number (R0) of HPV infection in different populations. R 0 affects the strength of herd protection and hence the impact of a vaccination program. Similar vaccination programs may therefore generate different levels of impact depending upon the population's pre‐vaccination HPV prevalence. We used IARC's transmission model to estimate (i) the overall effectiveness of vaccination versus no vaccination in women aged 15–34 years measured as percent prevalence reduction (%PR) of HPV16 and (ii) the corresponding herd protection in populations with gender‐equal or traditional sexual behavior and with different levels of sexual activity, corresponding to pre‐vaccination HPV16 prevalence from 1 to 8% as observed worldwide. Between populations with different levels of gender‐equal sexual activity, the highest difference in %PR under girls‐only vaccination is observed at 40% coverage (91%PR vs. 48%PR for 1% and 8% pre‐vaccination prevalence, respectively). HPV16 elimination is obtained with 55 and 97% coverage, respectively. To achieve desirable levels of HPV16 prevalence after vaccination, different levels of coverage are required in populations with different levels of pre‐vaccination HPV16 prevalence, for example, in populations with gender‐equal sexual behavior a decrease to 1/1000 HPV16 from pre‐vaccination prevalence of 1 and 8% would require coverages of 37 and 96%, respectively. In traditional populations, corresponding coverages would need to be 28 and 93%, respectively. In conclusion, pre‐vaccination HPV prevalence strongly influences herd immunity and helps predict the overall effectiveness of HPV vaccination.

show abstract

Section: Discussionmentioning

confidence: 99%

“…We then fitted our model to HPV16 age‐specific prevalence curves in Italian women (Supporting Information Fig. S1)11, 18, 19 by calibrating the rate of clearance of HPV16 infection. HPV16 clearance rate was found to decrease with time since infection (Supporting Information Table S1), in accordance with empirical evidence 20, 21.…”

Section: Methodsmentioning

confidence: 99%

Impacts of human papillomavirus vaccination for different populations: A modeling study

Baussano

Lazzarato

Ronco³

et al. 2018

Intl Journal of Cancer

Self Cite

View full text Add to dashboard Cite

show abstract

“…Women aged 25–60 years who were not pregnant, had never underwent hysterectomy, had not been treated for CIN in the last 5 years and who were attending for a new routine cervical screening episode were randomly assigned, between February 2002 and December 2004, to conventional cytology (classified according to the Bethesda 1991 system and managed according to the standard protocol of each centre) or to HPV‐based screening, either in combination with liquid‐based cytology (phase 1)14, 15 or alone (phase 2) 16. Details on randomization and masking have been reported previously 14, 15, 16, 17…”

Section: Methodsmentioning

confidence: 99%

“…The same exercise was repeated at the time of the second screening round. The results of such reviews were previously reported 14, 16, 17, 22, 23. Adenocarcinoma in situ was considered with CIN3.…”

Section: Methodsmentioning

confidence: 99%

“…Adenocarcinoma in situ was considered with CIN3. In addition, to obtain histological diagnoses performed outside the trial, after the end of the second round, we linked the database of recruited women to those of the cancer registries (covering all centres except Viterbo) and of the Pathology Units present in the catchment areas of NTCC 17. Considering the women included in this analysis, 44 of 224 (19.6%) with histology locally diagnosed as CIN2+ at baseline or follow‐up were downgraded to CIN1 or no CIN while 19 of 406 (4.7%) with histology locally diagnosed as CIN1 were upgraded to CIN2 or more severe.…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Human papilloma virus genotyping for the cross‐sectional and longitudinal probability of developing cervical intraepithelial neoplasia grade 2 or more

Mistro

Adcock

Carozzi

et al. 2018

Intl Journal of Cancer

Self Cite

View full text Add to dashboard Cite

Human papilloma virus (HPV) testing is more sensitive but less specific than cytology. We evaluated stand‐alone genotyping as a possible triage method. During a multicentre randomised controlled trial comparing HPV testing to conventional cytology, HPV‐positive women were referred to colposcopy and followed up if no high‐grade lesion was detected. HPV‐positive samples were genotyped by GP5+/GP6+ primed polymerase chain reaction followed by reverse line blot. Genotypes were hierarchically ordered by positive predictive value (PPV) for CIN grade 2 or more (CIN2+), and grouped by cluster analysis into three groups (A, B and C in decreasing order). Receiver operating characteristic curves were computed. Among 2,255 HPV‐positive women with genotyping, 239 CIN2+ (including 113 CIN3+) were detected at baseline or during a 3‐year follow‐up. HPV33 had the highest PPV with CIN2+ and CIN3+ as the endpoint and when considering lesions detected at baseline or also during follow‐up. HPV16 and HPV35 were the second and third, respectively. Cross‐sectional sensitivity for CIN2+ at baseline was 67.3% (95% CI 59.7–74.2), 91.8% (95% CI 86.6–95.5) and 94.7% (95% CI 90.2–97.6), respectively, when considering as “positive” any of the HPV types in group A (33, 16 and 35), A or B (31, 52, 18, 59 and 58) and A or B or C (39, 51, 56, 45 and 68). The corresponding cross‐sectional PPVs for CIN2+ were 15.8% 95% (CI 13.2–18.7), 12.0% (95% CI 10.3–13.9) and 9.6% (95% CI 8.2–11.1), respectively. HPV33, 16 and 35 confer a high probability of CIN2+ but this rapidly decreases when adding other genotypes.

show abstract

Why Consider Self-Sampling for Cervical Cancer Screening in Low- and Middle-Income Countries?

Defo

Domgue

2020

AMA Journal of Ethics

View full text Add to dashboard Cite

Molecular detection of high-risk human papillomavirus (HPV) in genital cells is being widely endorsed as a preferred tool for cervical cancer screening globally. In low-and middle-income countries (LMICs) where cervical cancer remains a leading killer, HPV testing is an appealing, accessible alternative to traditional cytology (ie, Pap smear) screening that enables women to self-collect specimens. This article examines selfsampling and its suitability as a strategy for cervical cancer prevention in LMICs that would promote equitable access to cervical cancer screening.

show abstract

Efficacy of human papillomavirus testing for the detection of invasive cervical cancers and cervical intraepithelial neoplasia: a randomised controlled trial

Cited by 840 publications

References 25 publications

Impacts of human papillomavirus vaccination for different populations: A modeling study

Impacts of human papillomavirus vaccination for different populations: A modeling study

Human papilloma virus genotyping for the cross‐sectional and longitudinal probability of developing cervical intraepithelial neoplasia grade 2 or more

Why Consider Self-Sampling for Cervical Cancer Screening in Low- and Middle-Income Countries?

Contact Info

Product

Resources

About