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Primary HPV screening for cervical cancer: Results after two screening rounds in a regional screening program in Finland.

宫颈癌的初级HPV筛查: 芬兰地区筛查项目两轮筛查后的结果。

  • 影响因子:2.21
  • DOI:10.1111/aogs.14021
  • 作者列表:"Veijalainen O","Kares S","Kotaniemi-Talonen L","Kujala P","Vuento R","Luukkaala T","Kholová I","Mäenpää J
  • 发表时间:2021-03-01
Abstract

INTRODUCTION:Since 2012, cervical cancer screening has been conducted with a primary high-risk human papillomavirus (hrHPV) test and conventional cytology triage in the city of Tampere, Finland. The women who were screened with the hrHPV test in 2012 were invited to participate in the second screening round in 2017. The aim of the present report was to compare the number of colposcopy referrals and the number of histological high-grade squamous intraepithelial lesion (HSIL)+ (cervical intraepithelial neoplasia [CIN2+]) lesions between the first and second screening rounds of women of a specific age group who were screened twice with the hrHPV test. MATERIAL AND METHODS:The primary hrHPV test used was the RealTime hrHPV PCR assay by Abbott. Women with a positive hrHPV test and cytology triage equal to or worse than low-grade squamous intraepithelial lesion or atypical glandular cells, favor neoplasia, were directly referred to colposcopy, whereas hrHPV-positive women with a negative or equivocal cytology triage were re-screened after approximately 12-16 months. hrHPV-negative women were scheduled for re-screening after 5 years. The present report focuses on the cohort of women who were screened twice with the hrHPV test, who were 35-55 years old in 2012, and 40-60 years old in 2017. RESULTS:In all, 8076 women were invited for HPV screening in 2012 and 8331 women were invited for the second round 5 years later, with attendance rates of 70% and 71%, respectively. Of the women who were screened in 2012, 4571 (69%) belonged to the 35- to 55-year age cohort. In 2017, 4807 (73%) of the women aged 40-60 years participated in the screening. In this cohort, 185 (4.0%) colposcopies were performed in the first screening round, compared with 139 (2.9%) in the second round, and the colposcopy rate was 29% smaller in the second round (P = .002). The number of histological HSIL+ cases was 38 (0.8%) during the first screening round and 29 (0.6%) during the second round (P = .220). CONCLUSIONS:In the setting of routine organized cervical cancer screening, the initially high colposcopy rate associated with primary HPV screening seems to level off at the second screening round in women who were screened twice with an hrHPV test.

摘要

简介: 自2012以来,在芬兰坦佩雷市开展了宫颈癌筛查,主要采用高危型人乳头瘤病毒 (hrHPV) 检测和常规细胞学分诊。2012年接受hrHPV检测筛查的女性受邀参加2017年第二轮筛查。本报告的目的是比较阴道镜转诊次数和组织学高级别鳞状上皮内病变 (HSIL)+ (宫颈上皮内瘤变 [CIN2 +]) 的数量用hrHPV测试筛查两次的特定年龄组女性的第一轮和第二轮筛查之间的病变。 材料和方法: 使用的主要hrHPV测试是Abbott的实时hrHPV PCR测定。hrHPV检测阳性和细胞学分诊结果与低级别鳞状上皮内病变或非典型腺细胞相似或更差的女性,可直接进行阴道镜检查,而hrHPV阳性的女性细胞学分诊结果为阴性或模棱两可,则在约12-16个月后再次进行筛查.hrHPV阴性的女性计划在5年后进行重新筛查。本报告的重点是使用hrHPV测试进行两次筛查的女性队列,这些女性在2012年为35-55岁,在2017年为40-60岁。 结果: 2012年共有8076名妇女被邀请进行HPV筛查,5年后第二轮被邀请8331名妇女,出勤率分别为70% 和71%。在2012年接受筛查的女性中,4571名 (69%) 属于35至55岁年龄组。在2017,4807 (73%) 的年龄在40-60岁的妇女参加了筛查。在该队列中,第一轮筛查中进行了185 (4.0%) 次阴道镜检查,而第二轮为139 (2.9%) 次,第二轮阴道镜检查率小29% (P = .002)。组织学HSIL + 病例数在第一轮筛选期间为38 (0.8%),在第二轮筛选期间为29 (0.6%) (P = .220)。 结论: 在常规有组织的宫颈癌筛查中,在用hrHPV检测进行两次筛查的女性中,最初与原发性HPV筛查相关的高阴道镜检查率似乎在第二轮筛查中持平。

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DOI:10.1007/s11033-021-06299-9
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