Journal
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY
Volume 205, Issue 6, Pages -Publisher
MOSBY-ELSEVIER
DOI: 10.1016/j.ajog.2011.06.101
Keywords
cervical cancer; cervical cytology; human papillomavirus; human papillomavirus genotypes; real-time polymerase chain reaction
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Funding
- Belgian Foundation Against Cancer, Brussels, Belgium
- European Commission (DG Sanco, Luxembourg)
- Flemish Fund for Scientific Research
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OBJECTIVE: The objective of the study was to investigate whether knowledge of human papillomavirus (HPV) deoxyribonucleic acid test results increases sensitivity of guided cytology screening for the detection of cervical intraepithelial neoplasia (CIN)-2 or higher-grade cervical lesions. STUDY DESIGN: This was a prospective colposcopy-controlled study of 2905 BD SurePath samples to identify cases with CIN2+ within a 24 month follow-up period. Sensitivity and specificity to detect CIN2+ was evaluated, comparing guided cytology screening with and without prior knowledge of HPV status. RESULTS: Prior knowledge of HPV status resulted in significantly higher detection rate of CIN2+ compared with screening blinded to HPV status (P = .005) with limited loss of specificity (P = .026). Gain in sensitivity is higher in older women (43.8%, P = .008) vs in younger women (10.2%, P = .317), whereas loss of specificity is more pronounced in younger women (P < .001) vs older women (P = .729). CONCLUSION: Guided cytological screening performed with prior knowledge of HPV status results in an improved detection of CIN2 or higher-grade lesions.
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