Role of human papillomavirus testing and cytology in follow-up after conization
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Role of human papillomavirus testing and cytology in follow-up after conization. / Gosvig, Camilla F; Huusom, Lene D; Deltour, Isabelle; Andersen, Klaus Kaae; Duun-Henriksen, Anne Katrine; Madsen, Ellen Merete; Petersen, Lone Kjeld; Elving, Lisbeth B; Schouenbourg, Lars; Iftner, Angelika; Svare, Edith; Iftner, Thomas; Kjaer, Susanne K.
In: Acta Obstetrica et Gynecologica, Vol. 94, No. 4, 04.2015, p. 405-11.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Role of human papillomavirus testing and cytology in follow-up after conization
AU - Gosvig, Camilla F
AU - Huusom, Lene D
AU - Deltour, Isabelle
AU - Andersen, Klaus Kaae
AU - Duun-Henriksen, Anne Katrine
AU - Madsen, Ellen Merete
AU - Petersen, Lone Kjeld
AU - Elving, Lisbeth B
AU - Schouenbourg, Lars
AU - Iftner, Angelika
AU - Svare, Edith
AU - Iftner, Thomas
AU - Kjaer, Susanne K
N1 - © 2015 Nordic Federation of Societies of Obstetrics and Gynecology.
PY - 2015/4
Y1 - 2015/4
N2 - OBJECTIVE: Adequate follow-up of women who have undergone conization for high-grade cervical lesions is crucial in cervical cancer screening programs. We evaluated the performance of testing for high-risk human papillomavirus (HPV) types, cytology alone, and combined testing in predicting cervical intraepithelial neoplasia grade 2 or worse (CIN2+) after conization.DESIGN: Prospective cohort study.SETTING: Denmark.POPULATION: 667 women attending for conization.METHODS: Cervical specimens were collected during 2002-2006 at first visit after conization for cytological examination and Hybrid Capture 2 detection of high-risk HPV. The women were passively followed until 2 years after first follow-up visit by linkage to the nationwide Pathology Data Bank.RESULTS: At first visit after conization (median time, 3.4 months), 20.4% were HPV-positive and 17.2% had atypical squamous intraepithelial lesions or more severe cytology (ASCUS+). The 2-year incidence of CIN2+ after conization was 3.6%. Sensitivity for detection of CIN2+ after conization was 81.0% [95% confidence interval (CI) 58.1-94.6] for positive cytology (ASCUS+ threshold) and 95.2% (95% CI 76.2-99.9) for HPV testing and for combined testing. Specificity of ASCUS+ cytology (85.2%; 95% CI 82.0-88.0) was higher than that of HPV testing (82.4%; 95% CI 79.0-85.4) and markedly higher than that of combined testing (73.2%; 95% CI 69.3-76.8). The margin status had no significant added value.CONCLUSIONS: Testing for high-risk HPV three to four months after conization is more sensitive than ASCUS+ cytology for identifying women at risk for relapse of CIN2+ within 2 years. Further studies are needed to evaluate whether HPV testing could be a stand-alone test in follow up after conization.
AB - OBJECTIVE: Adequate follow-up of women who have undergone conization for high-grade cervical lesions is crucial in cervical cancer screening programs. We evaluated the performance of testing for high-risk human papillomavirus (HPV) types, cytology alone, and combined testing in predicting cervical intraepithelial neoplasia grade 2 or worse (CIN2+) after conization.DESIGN: Prospective cohort study.SETTING: Denmark.POPULATION: 667 women attending for conization.METHODS: Cervical specimens were collected during 2002-2006 at first visit after conization for cytological examination and Hybrid Capture 2 detection of high-risk HPV. The women were passively followed until 2 years after first follow-up visit by linkage to the nationwide Pathology Data Bank.RESULTS: At first visit after conization (median time, 3.4 months), 20.4% were HPV-positive and 17.2% had atypical squamous intraepithelial lesions or more severe cytology (ASCUS+). The 2-year incidence of CIN2+ after conization was 3.6%. Sensitivity for detection of CIN2+ after conization was 81.0% [95% confidence interval (CI) 58.1-94.6] for positive cytology (ASCUS+ threshold) and 95.2% (95% CI 76.2-99.9) for HPV testing and for combined testing. Specificity of ASCUS+ cytology (85.2%; 95% CI 82.0-88.0) was higher than that of HPV testing (82.4%; 95% CI 79.0-85.4) and markedly higher than that of combined testing (73.2%; 95% CI 69.3-76.8). The margin status had no significant added value.CONCLUSIONS: Testing for high-risk HPV three to four months after conization is more sensitive than ASCUS+ cytology for identifying women at risk for relapse of CIN2+ within 2 years. Further studies are needed to evaluate whether HPV testing could be a stand-alone test in follow up after conization.
KW - Adult
KW - Cervical Intraepithelial Neoplasia
KW - Conization
KW - Early Detection of Cancer
KW - Female
KW - Follow-Up Studies
KW - Humans
KW - Neoplasm Recurrence, Local
KW - Papillomavirus Infections
KW - Prospective Studies
KW - Sensitivity and Specificity
KW - Uterine Cervical Neoplasms
KW - Vaginal Smears
U2 - 10.1111/aogs.12601
DO - 10.1111/aogs.12601
M3 - Journal article
C2 - 25645089
VL - 94
SP - 405
EP - 411
JO - Acta Obstetricia et Gynecologica Scandinavica
JF - Acta Obstetricia et Gynecologica Scandinavica
SN - 0001-6349
IS - 4
ER -
ID: 162033674