Incidence of cervical high‐grade squamous intraepithelial lesions and squamous cell carcinoma in women with high‐risk human papillomavirus and normal cervical cytology: A retrospective analysis of 1858 cases stratified by age and human papillomavirus genotype

et al. 2020

BMC Cancer

Background Human papillomavirus (HPV) testing is more sensitive than cytology for detecting cervical cancer and its precursors. This study aimed to analyze the prevalence of high-risk HPV genotypes and evaluate the role of HPV genotyping triage for detecting high-grade squamous intraepithelial lesions, adenocarcinoma in situ and cervical cancer (HSIL+) in HPV-positive women with normal cytology. Methods A retrospective study was performed in women who had undergone co-screening at the China Medical University-affiliated Shengjing Hospital between 2012 and 2014. Results Of the 34,587 women, 2665 HPV-positive women with normal cytology who had received colposcopy were eligible for analysis. In HSIL+ groups of 204 women, the common genotypes were HPV16, HPV52, HPV58, HPV33, HPV31 and HPV18 in order of prevalence. The proportion of histological HSIL+ in women infected with HPV33 or HPV31 was not significantly different compared to women infected with HPV16 (P = 0.30, P = 0.19, respectively). The odds ratios for histological HSIL+ were 3.26 (95% confidence interval [CI]: 2.41–4.40) in women with HPV16/18, 4.21 (95% CI: 2.99–5.93) in those with HPV16/18/31/33, and 5.73 (95% CI: 3.30–9.97) in those with HPV16/18/31/33/52/58. Including HPV31/33 genotyping together with HPV16/18 significantly increased the proportion of HSIL+ detection from 63.2 to 77.5% (P = 0.002) without significantly increasing the colposcopy per HSIL+ detection ratio (7.7 to 8.1, P = 0.66). Conclusions HPV genotyping played an important role in managing HPV-positive women with normal cytology. Genotyping for HPV31/33 should be added to the previously recommended HPV16/18 genotyping in triaging HPV-positive women in northeastern China.

Section: Characteristics Of the Study Populationmentioning

confidence: 99%

The role of human papillomavirus genotyping for detecting high-grade intraepithelial neoplasia or cancer in HPV-positive women with normal cytology: a study from a hospital in northeastern China

et al. 2020

BMC Cancer

“…The triage of HPV primary screening faces the same problem. Several studies have shown that the current cervical screening strategy with HPV16/18 genotyping misses some non-HPV16/18 infected women who progress to high-grade cervical lesions or cancer [18,19]. The present study was a real-world study and evaluated the prevalence of hrHPV genotypes and the correlation with HSIL+ risk, especially in hrHPV positive women with normal cytology.…”

Section: Discussionmentioning

confidence: 94%

“…(75.8%), HPV53 (75.4%), HPV18 (74.4%) and HPV51 (70.65%) than other hrHPV genotypes (Table 1). 19.1% (39/204) in the HSIL+ group. In the squamous cervical cancer group, the prevalence of HPV16 (18/24, 75%) was prominent.…”

Section: Hrhpv Positive Women With Normal Cytologymentioning

confidence: 98%

The role of human papillomavirus genotyping for detecting high-grade intraepithelial neoplasia or cancer in HPV-positive women with normal cytology: a study from a hospital in northeastern China

et al. 2020

Preprint

Background: Human papillomavirus (HPV) testing is more sensitive than cytology for detecting cervical cancer and its precursors. This study aimed to analyze the prevalence of high-risk HPV genotypes and evaluate the role of HPV genotyping triage for detecting high-grade squamous intraepithelial lesions, adenocarcinoma in situ and cervical cancer (HSIL+) in HPV-positive women with normal cytology.Methods: A retrospective study was performed in women who had undergone co-screening at the China Medical University-affiliated Shengjing Hospital between 2012 and 2014. Results: Of the 34,587 women, 2,665 HPV-positive women with normal cytology who had received colposcopy were eligible for analysis. In HSIL+ groups of 204 women, the common genotypes were HPV16, HPV52, HPV58, HPV33, HPV31 and HPV18 in order of prevalence. The proportion of histological HSIL+ in women infected with HPV33 or HPV31 was not significantly different compared to women infected with HPV16 (P= 0.30, P= 0.19, respectively). The odds ratios for histological HSIL+ were 3.26 (95% confidence interval [CI]: 2.41–4.40) in women with HPV16/18, 4.21 (95% CI: 2.99–5.93) in those with HPV16/18/31/33, and 5.73 (95% CI: 3.30–9.97) in those with HPV16/18/31/33/52/58. Including HPV31/33 genotyping together with HPV16/18 significantly increased the proportion of HSIL+ detection from 63.2% to 77.5% (P = 0.002) without significantly increasing the colposcopy per HSIL+ detection ratio (7.7 to 8.1, P = 0.66). Conclusion: HPV genotyping played an important role in managing HPV-positive women with normal cytology. Genotyping for HPV31/33 should be added to the previously recommended HPV16/18 genotyping in triaging HPV-positive women in northeastern China.

“…The triage of HPV primary screening faces the same problem. Several studies have shown that the current cervical screening strategy with HPV16/18 genotyping misses a part of non-HPV16/18 infected women who progress to high-grade cervical lesions or cancer [17,18]. The present study was a real-world study and evaluated the prevalence of hrHPV genotypes and the correlation with HSIL+ risk, especially in women with negative cytology and hrHPV positivity.…”

Section: Discussionmentioning

confidence: 95%

“…A metaanalysis reported that the most common HPV types detected in invasive cervical cancer (ICC) cases from Eastern Asia were HPV16, 18, 58, 52, 33, 31, 45, and 59 [11]. Another study showed that in cervical intraepithelial neoplasia (CIN) 2/3 and adenocarcinoma in situ samples, HPV 16,52,58,51,33,31,18, and 35 were the most common HPV types in five Asian countries [12].The data collected from other countries may not, therefore, represent the situation in China [13,14].…”

mentioning

confidence: 99%

The role of human papillomavirus genotyping for detecting high-grade intraepithelial neoplasia or cancer in HPV-positive women with normal cytology: A study from a hospital in northeastern China

et al. 2020

Preprint

Background: Human papillomavirus (HPV) testing is more sensitive than cytology for detecting cervical cancer and its precursors. This study aimed to analyze the prevalence of high-risk HPV genotypes and evaluate the role of HPV genotyping triage for detecting high-grade squamous intraepithelial lesions, adenocarcinoma in situ and cervical cancer (HSIL+) in HPV-positive women with normal cytology. Methods: A retrospective study was performed in women who had undergone co-screening at the China Medical University-affiliated Shengjing Hospital between 2012 and 2014. Results: Of the 34,587 women, 2,665 HPV-positive women with normal cytology who had received colposcopy were eligible for analysis. In HSIL+ groups of 204 women, the common genotypes were HPV16, HPV52, HPV58, HPV33, HPV31 and HPV18. The proportion of histological HSIL+ in women infected with HPV33 or HPV31 was not significantly different compared to women infected with HPV16 ( P = 0.30, P = 0.19, respectively).The odds ratios for histological HSIL+ were 3.26 (95% confidence interval [CI]: 2.41–4.40) in women with HPV16/18, 4.21 (95% CI: 2.99–5.93) in those with HPV16/18/31/33, and 5.73 (95% CI: 3.30–9.97) in those with HPV16/18/31/33/52/58. Including HPV31/33 genotyping together with HPV16/18 significantly increased the proportion of HSIL+ detection from 63.2% to 77.5% ( P = 0.002). Moreover, the colposcopy per HSIL+ detection ratio only slightly increased from 7.7 to 8.1 ( P = 0.66). Conclusion: HPV genotyping played an important role in managing HPV-positive women with normal cytology. Genotyping for HPV31/33 should be added to the previously recommended HPV16/18 genotyping in triaging HPV-positive women in northeastern China.