2000
DOI: 10.1001/jama.283.1.87
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HPV DNA Testing in Cervical Cancer Screening

Abstract: In this study population, a cut point of 1.0 pg/mL using the second generation assay permitted sensitive detection of cervical high-grade lesions and cancer, yielding an apparently optimal trade-off between high sensitivity and reasonable specificity for this test. The test will perform best in settings in which sensitive detection of high-grade lesions and cancer is paramount. Because HPV prevalence varies by population, HPV testing positive predictive value for detection of high-grade lesions and cancer will… Show more

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Cited by 467 publications
(59 citation statements)
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“…Then, the number of abnormal cells per sample would be much more important and, consequently, the sensitivity gap between HPV and cytology for detection of HSIL would be much smaller. This idea is supported in the literature, as studies performed in a high-risk population demonstrated relatively small gaps (4, 10, 10 and 15%) (Belinson et al, 1999;Kuhn et al, 2000;Schiffman et al, 2000;Wright et al, 2000) compared with studies performed in a low-risk population with higher gaps (30, 38, 54 and 55%) (Ratnam et al, 2000;Clavel et al, 2001;Kulasingam et al, 2002;Petry et al, 2003).…”
Section: Contribution Of Hpv Viral Load Studymentioning
confidence: 83%
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“…Then, the number of abnormal cells per sample would be much more important and, consequently, the sensitivity gap between HPV and cytology for detection of HSIL would be much smaller. This idea is supported in the literature, as studies performed in a high-risk population demonstrated relatively small gaps (4, 10, 10 and 15%) (Belinson et al, 1999;Kuhn et al, 2000;Schiffman et al, 2000;Wright et al, 2000) compared with studies performed in a low-risk population with higher gaps (30, 38, 54 and 55%) (Ratnam et al, 2000;Clavel et al, 2001;Kulasingam et al, 2002;Petry et al, 2003).…”
Section: Contribution Of Hpv Viral Load Studymentioning
confidence: 83%
“…After 50 years of cytology as the sole test in cervical cancer prevention, new methods are appearing to palliate the Achilles' heel of cytology, which is sensitivity. Indeed, many reports (Belinson et al, 1999;Kuhn et al, 2000;Ratnam et al, 2000;Schiffman et al, 2000;Wright et al, 2000;Clavel et al, 2001;Kulasingam et al, 2002;Petry et al, 2003) have established a higher sensitivity for HPV than for cytology, although published results are not unanimous (de Cremoux et al, 2003). The main study objective was to confirm the better sensitivity of HPV testing, especially in the context of routine clinical practice.…”
mentioning
confidence: 98%
“…In the Guanacaste trial, sensitivity and specificity of the HC 2 r testing were compared to Pap testing using ASC-US cut point for colposcopy (Schiffman et al, 2000); however, the women tested for hrHPVs had multiple tests (a pelvic examination, conventional cytological test and LBC test, cervigrams) performed, which makes evaluating the outcome effectiveness of these tests impossible (The working group of IARC, 2005). Like in our study, in the ALTS and POBASCAM trial women were randomised to intervention and control groups, but in these trials hrHPV test (by HC 2 r in ALTS and by GP5 þ /6 þ PCR immunoassay in POBASCAM) was used as a confirmatory test for cytological test, which is just the opposite to our study (Schiffman and Solomon, 2003;Bulkmans et al, 2004).…”
Section: Discussionmentioning
confidence: 99%
“…Moreover, only low-grade SIL (LSIL) containing HR-HPV progress to high-grade SIL (HSIL) (Koutsky et al, 1992). Owing to this, there is an increasing interest in using HPV DNA detection either alone or in addition to classic cytological examination for primary cervical screening (Cuzick et al, 1995(Cuzick et al, , 1999(Cuzick et al, , 2003Meijer et al, 1998;Clavel et al, 1999Clavel et al, , 2001Kuhn et al, 2000;Ratnam et al, 2000;Schiffman et al, 2000;Schneider et al 2000;Kjaer et al, 2002;Petry et al, 2003;Lorincz and Richart, 2003;Sherman et al, 2003). Most authors consider that a positive HPV testing selects a population at high risk for developing an HSIL, while a negative HPV testing has a very good negative predictive value (NPV).…”
mentioning
confidence: 99%