dc.contributor.author |
Ibáñez, Raquel |
dc.contributor.author |
Moreno Crespi, Judit |
dc.contributor.author |
Sardà, Montserrat |
dc.contributor.author |
Autonell, Josefina |
dc.contributor.author |
Fibla, Montserrat |
dc.contributor.author |
Gutiérrez Miguélez, Cristina |
dc.contributor.author |
Lloveras, Belen |
dc.contributor.author |
Alejo, Maria |
dc.contributor.author |
Català, Isabel |
dc.contributor.author |
Alameda, Francesc |
dc.contributor.author |
Casas, Miquel |
dc.contributor.author |
Bosch José, Francesc Xavier, 1947- |
dc.contributor.author |
Sanjosé Llongueras, Silvia de |
dc.date |
2018-11-28T10:28:28Z |
dc.date |
2018-11-28T10:28:28Z |
dc.date |
2012-01-26 |
dc.date |
2018-07-24T12:56:44Z |
dc.identifier.uri |
http://hdl.handle.net/2445/126534 |
dc.format |
8 p. |
dc.format |
application/pdf |
dc.language.iso |
eng |
dc.publisher |
BioMed Central |
dc.relation |
Reproducció del document publicat a: https://doi.org/10.1186/1471-2334-12-25 |
dc.relation |
BMC Infectious Diseases, 2012, vol. 12, num. 25 |
dc.relation |
https://doi.org/10.1186/1471-2334-12-25 |
dc.rights |
cc by (c) Ibáñez et al., 2012 |
dc.rights |
info:eu-repo/semantics/openAccess |
dc.rights |
http://creativecommons.org/licenses/by/3.0/es/ |
dc.subject |
Càncer de coll uterí |
dc.subject |
Papil·lomavirus |
dc.subject |
Cervix cancer |
dc.subject |
Papillomaviruses |
dc.title |
Prediction of cervical intraepithelial neoplasia grade 2+ (CIN2+) using HPV DNA testing after a diagnosis of atypical squamous cell of undetermined significance (ASC-US) in Catalonia, Spain |
dc.type |
info:eu-repo/semantics/article |
dc.type |
info:eu-repo/semantics/publishedVersion |
dc.description.abstract |
Background: A protocol for cervical cancer screening among sexually active women 25 to 65 years of age was introduced in 2006 in Catalonia, Spain to increase coverage and to recommend a 3-year-interval between screening cytology. In addition, Human Papillomavirus (HPV) was offered as a triage test for women with a diagnosis of atypical squamous cells of undetermined significance (ASC-US). HPV testing was recommended within 3 months of ASC-US diagnosis. According to protocol, HPV negative women were referred to regular screening including a cytological exam every 3 years while HPV positive women were referred to colposcopy and closer follow-up. We evaluated the implementation of the protocol and the prediction of HPV testing as a triage tool for cervical intraepithelial lesions grade two or worse (CIN2+) in women with a cytological diagnosis of ASC-US. Methods: During 2007-08 a total of 611 women from five reference laboratories in Catalonia with a novel diagnosis of ASC-US were referred for high risk HPV (hrHPV) triage using high risk Hybrid Capture version 2. Using routine record linkage data, women were followed for 3 years to evaluate hrHPV testing efficacy for predicting CIN2+ cases. Logistic regression analysis was used to estimate the odds ratio for CIN2 +. Results: Among the 611 women diagnosed with ASC-US, 493 (80.7%) had at least one follow-up visit during the study period. hrHPV was detected in 48.3% of the women at study entry (mean age 35.2 years). hrHPV positivity decreased with increasing age from 72.6% among women younger than 25 years to 31.6% in women older than 54 years (p < 0.01). At the end of the 3 years follow-up period, 37 women with a diagnosis of CIN2+ (18 CIN2, 16 CIN3, 2 cancers, and 1 with high squamous intraepithelial lesions -HSIL) were identified and all but one had a hrHPV positive test at study entry. Sensitivity to detect CIN2+ of hrHPV was 97.2% (95%confidence interval (CI) = 85.5-99.9) and specificity was 68.3% (95%CI = 63.1-73.2). The odds ratio for CIN2+ was 45.3 (95% CI: 6.2-333.0), when among ASC-US hrHPV positive women were compared to ASC-US hrHPV negative women. Conclusions: Triage of ASC-US with hrHPV testing showed a high sensitivity for the detection of CIN2+ and a high negative predictive value after 3 years of follow-up. The results of this study are in line with the current guidelines for triage of women with ASC-US in the target age range of 25-65. Non adherence to guidelines will lead to unnecessary medical interventions. Further investigation is needed to improve specificity of ASC-US triage. |