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Infectious Agents and Cancer
Published in: Infectious Agents and Cancer 1/2015

Open Access 01-12-2015 | Research Article

HPV16/18 genotyping for the triage of HPV positive women in primary cervical cancer screening in Chile

Authors: Marcela Lagos, Vanessa Van De Wyngard, Helena Poggi, Paz Cook, Paola Viviani, María Isabel Barriga, Martha Pruyas, Catterina Ferreccio

Published in: Infectious Agents and Cancer | Issue 1/2015

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Abstract

Background

We previously conducted a population-based screening trial of high-risk human papillomavirus (hrHPV) testing and conventional cytology, demonstrating higher sensitivity (92.7 % vs 22.1 % for CIN2+) but lower positive predictive value (10.5 % vs 23.9 %) of hrHPV testing. Here we report the performance of HPV16/18 genotyping to triage the hrHPV positive participants.

Methods

Women aged 25 years and older received hrHPV (Hybrid Capture 2) and Papanicolaou testing; positives by either test underwent colposcopy and directed biopsy, as did a sample of double-negatives. hrHPV positive women were reflex-tested with HPV16/18 genotyping (Digene HPV Genotyping PS Test).

Results

Among the 8,265 participants, 10.7 % were hrHPV positive, 1.7 % had ASCUS+ cytology, 1.2 % had CIN2+; 776 (88 %) hrHPV positive women had complete results, of whom 38.8 % were positive for HPV16 (24.0 %), HPV18 (9.7 %) or both (5.1 %). CIN2+ prevalence in HPV16/18 positive women (16.3 %, 95 % CI 12.3-20.9) was twice that of HPV16/18 negative women (8.0 %, 95 % CI 5.7-10.8). HPV16/18 genotyping identified 40.5 % of CIN2, 66.7 % of CIN3 and 75.0 % of cancers. Compared to hrHPV screening alone, HPV16/18 triage significantly reduced the referral rate (10.7 % vs 3.7 %) and the number of colposcopies required to detect one CIN2+ (9 vs 6). When HPV16/18 negative women with baseline ASCUS+ cytology were also colposcopied, an additional 14 % of CIN2+ was identified; referral increased slightly to 4.2 %.

Conclusions

HPV16/18 triage effectively stratified hrHPV positive women by their risk of high-grade lesions. HPV16/18 positive women must be referred immediately; referral could be deferred in HPV16/18 negative women given the slower progression of non-HPV16/18 lesions, however, they will require active follow-up.
Literature
1.
2.
3.
Ferreccio C, Barriga MI, Lagos M, Ibanez C, Poggi H, Gonzalez F, et al. Screening trial of human papillomavirus for early detection of cervical cancer in Santiago, Chile. Int J Cancer. 2013;132(4):916–23.CrossRefPubMed
4.
Arbyn M, Ronco G, Anttila A, Meijer CJLM, Poljak M, Ogilvie G, et al. Evidence regarding human papillomavirus testing in secondary prevention of cervical cancer. Vaccine. 2012;30S:F88–99.CrossRef
5.
Ronco G, Dillner J, Elfström KM, Tunesi S, Snijders PJF, Arbyn M, et al. Efficacy of HPV-based screening for prevention of invasive cervical cancer: follow-up of four European randomised controlled trials. Lancet. 2014;383:524–32.CrossRefPubMed
6.
de Sanjose S, Quint WGV, Alemany L, Geraets DT, Klaustermeier JE, Lloveras B, et al. Human papillomavirus genotype attribution in invasive cervical cancer: a retrospective cross-sectional worldwide study. Lancet Oncol. 2010;11:1048–56.CrossRefPubMed
7.
Li N, Franceschi S, Howell-Jones R, Snijders PJF, Clifford GM. Human papillomavirus type distribution in 30,848 invasive cervical cancers worldwide: variation by geographical region, histological type and year of publication. Int J Cancer. 2011;128:927–35.CrossRefPubMed
8.
Khan MJ, Castle PE, Lorincz AT, Wacholder S, Sherman M, Scott DR, et al. The elevated 10-Year Risk of Cervical Precancer and Cancer in Women With Human Papillomavirus (HPV) Type 16 or 18 and the Possible Utility of Type-Specific HPV Testing in Clinical Practice. J Natl Cancer Inst. 2005;97:1072–9.CrossRefPubMed
9.
Bulk S, Bulkmans NWJ, Berkhof J, Rozendaal L, Boeke AJP, Verheijen RHM, et al. Risk of high-grade cervical intra-epithelial neoplasia based on cytology and high-risk HPV testing at baseline and at 6-months. Int J Cancer. 2007;121:361–7.CrossRefPubMed
10.
Kjaer SK, Frederiksen K, Munk C, Iftner T. Long-term Absolute Risk of Cervical Intraepithelial Neoplasia Grade 3 or Worse Following Human Papillomavirus Infection: Role of Persistence. J Natl Cancer Inst. 2010;102:1478–88.PubMedCentralCrossRefPubMed
11.
Clifford GM, Smith JS, Aguado T, Franceschi S. Comparison of HPV type distribution in high-grade cervical lesions and cervical cancer: a meta-analysis. Brit J Cancer. 2003;89:101–5.PubMedCentralCrossRefPubMed
12.
Smith JS, Lindsay L, Hoots B, Keys J, Franceschi S, Winer R, et al. Human papillomavirus type distribution in invasive cervical cancer and high-grade cervical lesions: A meta-analysis update. Int J Cancer. 2007;121:621–32.CrossRefPubMed
13.
Benoy IH, Broeck DV, Ruymbeke MJ, Sahebali S, Arbyn M, Bogers JJ, et al. Prior knowledge of HPV status improves detection of CIN2 by cytology screening. Am J Obstet Gynecol. 2011;205:569.e1–7.CrossRef
14.
Wright TC, Stoler MH, Behrens CM, Apple R, Derion T, Wright TL. The ATHENA human papillomavirus study: design, methods, and baseline results. Am J Obstet Gynecol. 2012;206:46.e1–11.CrossRef
15.
Ili CG, Brebi P, Lopez J, Garcia P, Leal P, Suarez E, et al. Genotyping of Human papillomavirus in Cervical Intraepithelial Neoplasia in a High-Risk Population. J Med Virol. 2011;83:833–7.CrossRefPubMed
16.
Castle PE, Stoler MH, Wright TC, Sharma A, Wright TL, Behrens CM. Performance of carcinogenic human papillomavirus (HPV) testing and HPV16 or HPV18 genotyping for cervical cancer screening of women aged 25 years and older: a subanalysis of the ATHENA study. Lancet Oncol. 2011;12:880–90.CrossRefPubMed
17.
Rijkaart DC, Berkhof J, van Kemenade FJ, Coupe VMH, Hesselink AT, Rozendaal L, et al. Evaluation of 14 triage strategies for HPV DNA-positive women in population-based cervical screening. Int J Cancer. 2012;130:602–10.CrossRefPubMed
18.
Naucler P, Ryd W, Törnberg S, Strand A, Wadell G, Elfgren K, et al. Efficacy of HPV DNA Testing With Cytology Triage and/or Repeat HPV DNA Testing in Primary Cervical Cancer Screening. J Natl Cancer Inst. 2009;101:88–99.CrossRefPubMed
19.
Castle PE, Lorincz AT, Mielzynska-Lohnas I, Scott DR, Glass AG, Sherman ME, et al. Results of Human Papillomavirus DNA Testing with the Hybrid Capture 2 Assay Are Reproducible. J Clin Microbiol. 2002;40:1088–90.PubMedCentralCrossRefPubMed
20.
Godinez JM, Tous S, Baixeras N, Moreno-Crespi J, Alejo M, Lejeune M, et al. Performance of the digene LQ, RH and PS HPVs genotyping systems on clinical samples and comparison with HC2 and PCR-based Linear Array. Infect Agents Canc. 2011;6:23.CrossRef
Metadata
Title
HPV16/18 genotyping for the triage of HPV positive women in primary cervical cancer screening in Chile
Authors
Marcela Lagos
Vanessa Van De Wyngard
Helena Poggi
Paz Cook
Paola Viviani
María Isabel Barriga
Martha Pruyas
Catterina Ferreccio
Publication date
01-12-2015
Publisher
BioMed Central
Published in
Infectious Agents and Cancer / Issue 1/2015
Electronic ISSN: 1750-9378
DOI
https://doi.org/10.1186/s13027-015-0038-5

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