High‐risk HPV testing vs liquid‐based cytology for cervical cancer screening among 25‐ to 30‐year‐old women: A historical cohort study
Abstract Introduction High‐risk human papilloma virus (hrHPV) DNA testing is more sensitive than cytology screening, achieving greater protection against cervical cancer. Controversy exists regarding the preferred screening method for women 25–30 years of age. At this age, infection with HPV is comm...
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Wiley
2023-02-01
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| Series: | Acta Obstetricia et Gynecologica Scandinavica |
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| Online Access: | https://doi.org/10.1111/aogs.14482 |
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| author | Ohad Feldstein Hadar Gali‐Zamir Eduardo Schejter Tali Feinberg Einav Yehuda‐Shnaidman Jacob Bornstein Tally Levy |
| author_facet | Ohad Feldstein Hadar Gali‐Zamir Eduardo Schejter Tali Feinberg Einav Yehuda‐Shnaidman Jacob Bornstein Tally Levy |
| author_sort | Ohad Feldstein |
| collection | DOAJ |
| description | Abstract Introduction High‐risk human papilloma virus (hrHPV) DNA testing is more sensitive than cytology screening, achieving greater protection against cervical cancer. Controversy exists regarding the preferred screening method for women 25–30 years of age. At this age, infection with HPV is common and usually transient. Consequently, hrHPV screening in this age group is fraught with high false‐positive screening results, leading to more colposcopies and unnecessary treatments with the potential for harm. In the present study, we aimed to compare the results of two screening methods in relation to high‐grade cervical intraepithelial lesion detection rate in the young age group of 25–30 years. Material and methods Retrospective information on cervical cytology, hrHPV testing, colposcopy referrals and histologic results, from one screening round, were retrieved from the Maccabi HealthCare Health Maintenance Organization centralized database during the study period from March 1, 2017 to April 1, 2019 for 25‐ to 30‐year‐old women. Screening with hrHPV testing for types 16, 18 and 12 other hrHPV types was compared with the conventional PAP liquid‐based cytology (LBC) test. Odds ratio (OR) of detection with 95% confidence interval (CI) was calculated for cervical intraepithelial neoplasia (CIN) grade 3 or higher (CIN 3+). Results During the study period, 42 244 women 25–30 years old underwent cervical cancer screening; of them, 20 997 were screened with LBC between March 1, 2017 and March 1, 2018 and compared with 21 247 who were screened with hrHPV between April 1, 2018 and April 1, 2019. Testing for hrHPV resulted in a higher colposcopy referral rate compared with primary LBC screening: 9.8% vs 7.8%, respectively; (OR 1.28; 95% CI 1.2–1.37; p < 0.001). Screening with hrHPV led to significantly higher detection of CIN 3+ lesions (OR 1.4; 95% CI 1.2–1.6; p < 0.001) compared with LBC. HPV infections with non‐16/18 hrHPV (other hrHPV) were the most prevalent (84.8%). Conclusions In women 25–30 years old, primary hrHPV screening was associated with a higher detection rate of CIN 3+ compared with cytology screening and should be considered for primary screening in this age group. |
| format | Article |
| id | doaj-art-6a3bc5dde9ea4844af2f1642ad1a180e |
| institution | DOAJ |
| issn | 0001-6349 1600-0412 |
| language | English |
| publishDate | 2023-02-01 |
| publisher | Wiley |
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| series | Acta Obstetricia et Gynecologica Scandinavica |
| spelling | doaj-art-6a3bc5dde9ea4844af2f1642ad1a180e2025-08-20T03:22:22ZengWileyActa Obstetricia et Gynecologica Scandinavica0001-63491600-04122023-02-01102222623310.1111/aogs.14482High‐risk HPV testing vs liquid‐based cytology for cervical cancer screening among 25‐ to 30‐year‐old women: A historical cohort studyOhad Feldstein0Hadar Gali‐Zamir1Eduardo Schejter2Tali Feinberg3Einav Yehuda‐Shnaidman4Jacob Bornstein5Tally Levy6Division of Gynecologic Oncology Department of Obstetrics and Gynecology Wolfson Medical Center and Sackler Faculty of Medicine Tel Aviv University Holon IsraelDivision of Gynecologic Oncology Department of Obstetrics and Gynecology Wolfson Medical Center and Sackler Faculty of Medicine Tel Aviv University Holon IsraelMaccabi HealthCare Services Rehovot IsraelMaccabi HealthCare Services Rehovot IsraelMaccabi HealthCare Services Rehovot IsraelDepartment of Obstetrics and Gynecology Galilee Medical Center and Azrieli Faculty of Medicine Bar Ilan University IsraelDivision of Gynecologic Oncology Department of Obstetrics and Gynecology Wolfson Medical Center and Sackler Faculty of Medicine Tel Aviv University Holon IsraelAbstract Introduction High‐risk human papilloma virus (hrHPV) DNA testing is more sensitive than cytology screening, achieving greater protection against cervical cancer. Controversy exists regarding the preferred screening method for women 25–30 years of age. At this age, infection with HPV is common and usually transient. Consequently, hrHPV screening in this age group is fraught with high false‐positive screening results, leading to more colposcopies and unnecessary treatments with the potential for harm. In the present study, we aimed to compare the results of two screening methods in relation to high‐grade cervical intraepithelial lesion detection rate in the young age group of 25–30 years. Material and methods Retrospective information on cervical cytology, hrHPV testing, colposcopy referrals and histologic results, from one screening round, were retrieved from the Maccabi HealthCare Health Maintenance Organization centralized database during the study period from March 1, 2017 to April 1, 2019 for 25‐ to 30‐year‐old women. Screening with hrHPV testing for types 16, 18 and 12 other hrHPV types was compared with the conventional PAP liquid‐based cytology (LBC) test. Odds ratio (OR) of detection with 95% confidence interval (CI) was calculated for cervical intraepithelial neoplasia (CIN) grade 3 or higher (CIN 3+). Results During the study period, 42 244 women 25–30 years old underwent cervical cancer screening; of them, 20 997 were screened with LBC between March 1, 2017 and March 1, 2018 and compared with 21 247 who were screened with hrHPV between April 1, 2018 and April 1, 2019. Testing for hrHPV resulted in a higher colposcopy referral rate compared with primary LBC screening: 9.8% vs 7.8%, respectively; (OR 1.28; 95% CI 1.2–1.37; p < 0.001). Screening with hrHPV led to significantly higher detection of CIN 3+ lesions (OR 1.4; 95% CI 1.2–1.6; p < 0.001) compared with LBC. HPV infections with non‐16/18 hrHPV (other hrHPV) were the most prevalent (84.8%). Conclusions In women 25–30 years old, primary hrHPV screening was associated with a higher detection rate of CIN 3+ compared with cytology screening and should be considered for primary screening in this age group.https://doi.org/10.1111/aogs.1448225–30 age groupcervical cancer screeningcervical intraepithelial neoplasiacolposcopyhrHPVliquid‐based cytology |
| spellingShingle | Ohad Feldstein Hadar Gali‐Zamir Eduardo Schejter Tali Feinberg Einav Yehuda‐Shnaidman Jacob Bornstein Tally Levy High‐risk HPV testing vs liquid‐based cytology for cervical cancer screening among 25‐ to 30‐year‐old women: A historical cohort study Acta Obstetricia et Gynecologica Scandinavica 25–30 age group cervical cancer screening cervical intraepithelial neoplasia colposcopy hrHPV liquid‐based cytology |
| title | High‐risk HPV testing vs liquid‐based cytology for cervical cancer screening among 25‐ to 30‐year‐old women: A historical cohort study |
| title_full | High‐risk HPV testing vs liquid‐based cytology for cervical cancer screening among 25‐ to 30‐year‐old women: A historical cohort study |
| title_fullStr | High‐risk HPV testing vs liquid‐based cytology for cervical cancer screening among 25‐ to 30‐year‐old women: A historical cohort study |
| title_full_unstemmed | High‐risk HPV testing vs liquid‐based cytology for cervical cancer screening among 25‐ to 30‐year‐old women: A historical cohort study |
| title_short | High‐risk HPV testing vs liquid‐based cytology for cervical cancer screening among 25‐ to 30‐year‐old women: A historical cohort study |
| title_sort | high risk hpv testing vs liquid based cytology for cervical cancer screening among 25 to 30 year old women a historical cohort study |
| topic | 25–30 age group cervical cancer screening cervical intraepithelial neoplasia colposcopy hrHPV liquid‐based cytology |
| url | https://doi.org/10.1111/aogs.14482 |
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