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Cervical Cancer Screening with DNA-HPV Testing and Precancerous Lesions Detection: A Brazilian Population-based Demonstration Study

Teixeira, Julio Cesar ; Vale, Diama Bhadra ; Discacciati, Michelle Garcia ; Campos, Cirbia Silva ; Bragança, Joana Froes ; Zeferino, Luiz Carlos

Revista Brasileira de ginecologia e obstetrícia, 2023-01, Vol.45 (1), p.021-030 [Periódico revisado por pares]

Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil: Thieme Revinter Publicações Ltda

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  • Título:
    Cervical Cancer Screening with DNA-HPV Testing and Precancerous Lesions Detection: A Brazilian Population-based Demonstration Study
  • Autor: Teixeira, Julio Cesar ; Vale, Diama Bhadra ; Discacciati, Michelle Garcia ; Campos, Cirbia Silva ; Bragança, Joana Froes ; Zeferino, Luiz Carlos
  • Assuntos: Adult ; Aged ; Brazil - epidemiology ; Child, Preschool ; DNA ; Early Detection of Cancer ; Female ; Humans ; Infant, Newborn ; OBSTETRICS & GYNECOLOGY ; Original Article | Artigo Original ; Original | Artigo Original ; Papillomavirus Infections - diagnosis ; Precancerous Conditions - diagnosis ; Uterine Cervical Neoplasms - diagnosis
  • É parte de: Revista Brasileira de ginecologia e obstetrícia, 2023-01, Vol.45 (1), p.021-030
  • Notas: ObjectType-Article-1
    SourceType-Scholarly Journals-1
    ObjectType-Feature-2
    content type line 23
  • Descrição: Abstract Objective  To evaluate the rates of precancerous lesions, colposcopy referral, and positive predictive value (PPV) by age groups of a population-based screening with DNA-HPV testing. Methods  The present demonstration study compared 16,384 HPV tests performed in the first 30 months of the program with 19,992 women tested in the cytology screening. The colposcopy referral rate and PPV for CIN2+ and CIN3+ by age group and screening program were compared. The statistical analysis used the chi-squared test and odds ratio (OR) with 95% confidence interval (95%CI). Results  The HPV tests were 3.26% positive for HPV16-HPV18 and 9.92% positive for 12 other HPVs with a 3.7 times higher colposcopy referral rate than the cytology program, which had 1.68% abnormalities. Human Papillomavirus testing detected 103 CIN2, 89 CIN3, and one AIS, compared with 24 CIN2 and 54 CIN3 detected by cytology ( p  < 0.0001). The age group between 25 and 29 years old screened by HPV testing had 2.4 to 3.0 times more positivity, 13.0% colposcopy referral, twice more than women aged 30 to 39 years old (7.7%; p  < 0.0001), and detected 20 CIN3 and 3 early-stage cancer versus 9 CIN3 and no cancer by cytology screening (CIN3 OR= 2.10; 95%CI: 0.91–5.25; p  = 0.043). The PPV of colposcopy for CIN2+ ranged from 29.5 to 41.0% in the HPV testing program. Conclusion  There was a significant increase in detections of cervix precancerous lesions in a short period of screening with HPV testing. In women < 30 years old, the HPV testing exhibited more positivity, high colposcopy referral rate, similar colposcopy PPV to older women, and more detection of HSIL and early-stage cervical cancer.
  • Editor: Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil: Thieme Revinter Publicações Ltda
  • Idioma: Inglês;Português
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