Primary cervical cancer screening with human papillomavirus: End of study results from the ATHENA study using HPV as the first-line screening test

Abstract

HPV primary screening in women ≥25years is as effective as a hybrid screening strategy that uses cytology if 25-29years and cotesting if ≥30years. However, HPV primary screening requires less screening tests.

Triage strategies in cervical cancer detection in Mexico: methods of the FRIDA Study

“…While the HPV ATHENA study was the first to explore different triage methods by incorporating HPV cytology screening algorithms as well as genotyping, the results of the ATHENA trial are representative of women undergoing cervical cancer screening in the United States, where the epidemiological pattern of HPV is different than in Mexico. 3,7 For example, in Latin American countries, the prevalence of hrHPV is greater among the older age groups, relative to that in North America, and this pattern is observed not only for the hrHPV types overall but also for the HPV-16/18 types. [32][33][34] To cater to the specific needs of the Mexican population, this study has lowered the age of HPV screening to age 30 instead of 35.…”

“…This extension of screening may help to reduce the burden of cervical disease in women aged 30 to 35 years, compared to cytology screening alone, as suggested in previous studies. 3,35 We furthermore seek to improve upon the current cytologic screening methods. We are using monolayer cytology and an automated process to ensure quality control of the cytological material and eliminate residues (blood, mucus) that hinder reading.…”

“…Leticia Torres-Ibarra, MSc, (1,2) Eduardo Lazcano-Ponce, DSc, (1) Eduardo L Franco, DPH, (3) Jack Cuzick, PhD,…”

“…These new tools include the detection of high-risk HPV types (hrHPV). 3 Transient hrHPV infections are, however, very common, and only a small proportion persist and lead to the development of cervical neoplasia. [4][5][6] As a result, a high proportion of hrHPV-positive women do not require colposcopy.…”

“…To date, there is no consensus on the most efficient and reliable triage strategy for hrHPV-positive women. 3,[8][9][10] These different triage methods must be further evaluated to determine which is most cost-effective in settings such as Mexico. There are various testing strategies that show great promise as potential triage tests, which could be performed on a single cervical sample.…”