Cervical cancer screening program and Human Papillomavirus (HPV) testing, part II : Update on HPV primary screening [printed text] / Marc Arbyn, Author ; Annemie Haelens, Author ; Anja Desomer, Author ; Freija Verdoodt, Author ; Nancy Thiry, Author ; Julie Francart, Author ; Germaine Hanquet, Author ; Jo Robays, Author . - Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre, 2015 . - 282 p. : ill;, ; A4. - ( KCE Reports. Health Technology Assessment (HTA); 238) . ISSN : D/2015/10.273/17 : € 0,00 Study n°2013-25_HTA_HPV_DNA_Testing Languages : English ( eng)
| Descriptors: |
Classification
WP 480 Cervix Uteri. Cervix Diseases -- Neoplasms
Indexation
Papillomavirus, Human ; 2013-25 ; Mass Screening ; R238 ; Uterine Cervical Neoplasms ; Vaginal Smears
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| Contents note: |
LIST OF FIGURES 7 -- LIST OF TABLES 13 -- LIST OF ABBREVIATIONS .20 -- SCIENTIFIC REPORT .22 -- 1 OPTIMAL FIRST SCREENING TEST .22 -- 1.1 UPDATE ON ACCURACY OF HPV VS. CYTOLOGY SCREENING 22 -- 1.1.1 Introduction .22 -- 1.1.2 Methods.24 -- 1.1.3 Results 25 -- 1.1.4 Relative cross-sectional accuracy 36 -- 1.1.5 Cross-sectional outcomes of randomised trials comparing cytology with HPV based screening 39 -- 1.1.6 Discussion 41 -- 1.2 EFFICACY AND EFFECTIVENESS OF HPV VS CYTOLOGY IN PRIMARY SCREENING FOR CERVICAL CANCER 42 -- 1.2.1 Introduction .42 -- 1.2.2 Clinical questions .42 -- 1.2.3 Results 43 -- 2 SCREENING INTERVAL FOR CYTOLOGICAL OR VIROLOGICAL SCREENING FOR CERVICAL CANCER .49 -- 2.1 SCREENING INTERVALS PROPOSED IN CURRENT GUIDELINES FOR CYTOLOGICAL SCREENING .49 -- 2.2 LOW RISK OF CERVICAL PRE-CANCER AND CANCER AFTER A NEGATIVE HRHPV DNA TEST OBSERVED IN SCREENED COHORTS .49 -- 2.3 INCREASED PROTECTION AGAINST CERVICAL CANCER DEMONSTRATED IN RANDOMISED TRIALS .52 -- 2.4 CONCLUSION 52 -- 3 TARGET AGE GROUP FOR CYTOLOGICAL OR VIROLOGICAL SCREENING FOR CERVICAL CANCER .53 -- 3.1 TARGET AGE GROUP PROPOSED IN CURRENT GUIDELINES FOR CYTOLOGICAL SCREENING .53 -- 3.2 AGE-SPECIFIC PREVALENCE OF HPV INFECTION 55 -- 3.3 VARIATION IN TEST ACCURACY OF CERVICAL CYTOLOGY AND HRHPV DNA TESTING BY AGE 57 -- 3.4 INFLUENCE OF AGE ON SCREENING EFFICACY 61 -- 3.5 AGE-SPECIFIC ADVERSE EFFECTS RELATED TO TREATMENT OF SCREEN-DETECTED LESIONS .61 -- 3.6 AGE TO STOP SCREENING 62 -- 3.7 CONCLUSION 63 -- 4 TRIAGE OF WOMEN WITH A POSITIVE HPV TEST AT SCREENING 63 -- 4.1 INTRODUCTION .63 -- 4.2 MATERIALS AND METHODS .63 -- 4.2.1 Clinical question 63 -- 4.2.2 Literature Search 64 -- 4.2.3 Statistical analysis 64 -- 4.3 RESULTS 65 -- 4.3.1 Literature retrieval 65 -- 4.3.2 Absolute accuracy of cytology and/or hrHPV-DNA based triage algorithms .67 -- 4.3.3 Triage with a combination of reflex cytology (cut-off ASC-US+) and HPV16 or HPV1618 genotyping 70 -- 4.3.4 Triage with reflex cytology (cut-off LSIL+) and combinations with HPV16 or HPV1618 genotyping 74 -- 4.3.5 Joint variation of sensitivity and specificity of 3 triage strategies .77 -- 4.3.6 Relative accuracy of cytology and/or hrHPV-DNA based triage algorithms versus reflex cytology (ASC-US+) 78 -- 4.3.7 p16INK4a immuno-cytochemistry .84 -- 4.4 RISK OF CIN3+ IN HRHPV-POSITIVE WOMEN WITH POSITIVE OR NEGATIVE TRIAGE TEST RESULTS 85 -- 4.5 DISCUSSION 90 -- 5 QUALITY CONTROL SYSTEMS 91 -- 5.1 QUALITY CONTROL SYSTEMS IN HPV TESTING 91 -- 5.1.1 Interpretation of the WHO HPV Laboratory Manual 2009 towards Belgian application 91 -- 5.1.2 Laboratory quality assurance .91 -- 5.1.3 Current situation in Belgian laboratories 92 -- 5.1.4 Role of a national HPV reference laboratory .93 -- 5.2 QUALITY CONTROL SYSTEMS IN CYTOLOGICAL TESTING 95 -- 5.2.1 How is it done abroad? .95 -- 5.2.2 Belgian situation 99 -- 5.2.3 Effectiveness of rescreening methods 100 -- 5.2.4 Discussion 101 -- 5.2.5 Conclusion 102 -- 6 CHARACTERISTICS OF CYTOLOGICAL SCREENING, CURRENT PREVALENCE OF HPV INFECTION, (BY AGE, CYTOLOGY, AREA), CYTO-VIROLOGICAL CORRELATION 103 -- 6.1 INTRODUCTION 103 -- 6.2 MATERIAL AND METHODS 103 -- 6.2.1 Study population and used tests 103 -- 6.2.2 Study questions 104 -- 6.2.3 Statistical analysis 104 -- 6.3 RESULTS 105 -- 6.3.1 Study and population characteristics 105 -- 6.3.2 Cytological findings 107 -- 6.3.3 Virological findings (monovariate analysis) 109 -- 6.3.4 Prevalence of HPV infection stratified by cytological category 110 -- 6.3.5 Influence of age 112 -- 6.3.6 Single and multiple high-risk HPV infections 116 -- 6.3.7 Geographical distribution of high-risk HPV infection 118 -- 6.3.8 Risk of cytological abnormalities associated with presence of human papillomavirus types 122 -- 6.3.9 Relation between occurrence of cytological lesions and presence of single or multiple HPV infections 125 -- 6.3.10 Multivariate analysis of the risk for HSIL+ associated with HPV types and other factors 126 -- 6.4 DISCUSSION 128 -- 6.4.1 Strengths 128 -- 6.4.2 Weakness 128 -- 6.4.3 Future research 128 -- 7 COMPARISON BELGIUM VERSUS THE NETHERLANDS: USE OF RESOURCES RELATED TO CERVICAL CANCER SCREENING VS. IMPACT 129 -- 7.1 INTRODUCTION 129 -- 7.2 MATERIAL AND METHODS 129 -- 7.2.1 Belgium 129 -- 7.2.2 The Netherlands 130 -- 7.3 RESULTS 130 -- 7.3.1 Burden of cervical cancer in Belgium and the Netherlands 130 -- 7.3.2 Incidence of cervical cancer 132 -- 7.3.3 Trend analysis of the mortality from cervical cancer 133 -- 7.3.4 Screening policies 134 -- 7.3.5 Intensity of screening 136 -- 8 COST IMPLICATIONS 137 -- 8.1 JUSTIFICATION OF THE MODELLING APPROACH 137 -- 8.2 ANALYTICAL CHOICES FOR THE COST IMPLICATIONS 138 -- 8.2.1 Model structure and (structural) assumptions 138 -- 8.2.2 Outcomes and comparator140 -- 8.2.3 Perspective 140 -- 8.2.4 Time horizon and discounting 140 -- 8.3 CLINICAL AND EPIDEMIOLOGICAL PARAMETERS 140 -- 8.3.1 Demographics 140 -- 8.3.2 Primary HPV screening 140 -- 8.3.3 Primary cytology screening 140 -- 8.3.4 ASCUS that undergo re-reading and HPV as triage test 141 -- 8.3.5 CIN1, CIN2 and CIN3 141 -- 8.3.6 Incidence of cervical cancer 141 -- 8.3.7 Effect of HPV screening on the incidence of cervical cancer 141 -- 8.3.8 Excess mortality due to cervical cancer 142 -- 8.4 ECONOMIC PARAMETERS 142 -- 8.4.1 Cytology 142 -- 8.4.2 HPV DNA 144 -- 8.4.3 Colposcopy 145 -- 8.4.4 Biopsy 145 -- 8.4.5 Cervical intra-epithelial neoplasia 146 -- 8.4.6 Cervical cancer 146 -- 8.4.7 Summary 147 -- 8.5 UNCERTAINTY 147 -- 8.6 RESULTS 148 -- 8.6.1 Base case 148 -- 8.6.2 Scenario analyses 149 -- 8.7 DISCUSSION 151 -- APPENDICES 153 |
| Link for e-copy: |
https://doi.org/10.57598/R238C |
| Format of e-copy: |
PDF (5.4 Mb) |
| Record link: |
https://kce.docressources.info/index.php?lvl=notice_display&id=3498 |
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