| 1. |
- Arbyn, M, et al.
(författare)
-
Clinical utility of HPV-DNA detection: Triage of minor cervical lesions, follow-up of women treated for high-grade CIN: An update of pooled evidence.
- 2005
-
Ingår i: Gynecol Oncol. - Academic Press. - 0090-8258. ; 99:3, Suppl 1, s. S7-S11
-
Tidskriftsartikel (refereegranskat)abstract
- Objective. Human papilloma virus (HPV) testing and repeat cytology are both proposed as methods to triage women with minor cytological cervical lesions. By triage, those women can be identified who need referral for diagnostic exploration with colposcopy and/or biopsy. Methods. We conducted meta-analyses of reported studies on the accuracy to detect high-grade cervical intra-epithelial neoplasia or worse disease (CIN2+) in women with ASCUS or LSIL. We also performed meta-analyses to examine the best predictor of recurrence of CIN after treatment for CIN2 or CIN3. Results. We found that HPV testing using the Hybrid Capture II test is more effective (more sensitive, equally specific) than cytology for the triage of patients with ASCUS Pap smears. Because of the high rate of HPV positivity, this is not the case for patients with LSIL. Studies concerning post-treatment follow-Lip were heterogeneous. In general, HPV testing performed better than follow-up cytology to predict success or failure of treatment (significantly higher sensitivity, not significantly lower specificity). Conclusions. Overall, in comparison with follow-up cytology, HPV DNA testing is more sensitive and equally specific for triage of ASCUS cases and for predicting recurrence of CIN in women treated for high-grade CIN.
|
|
| 2. |
- Arbyn, M, et al.
(författare)
-
Methods for screening and diagnosis
- 2007
-
Ingår i: 2nd edition of the EU Guidelines for cervical cancer screening. - European Commission Office for Official Publication of the European Communities. - 978-92-79-07698-5 ; s. 69-141
-
Bokkapitel (övrigt vetenskapligt)
|
|
| 3. |
|
|
| 4. |
- Arbyn, M, et al.
(författare)
-
Virologic versus cytologic triage of women with equivocal pap smears: A meta-analysis of the accuracy to detect high-grade intraepithelial neoplasia
- 2004
-
Ingår i: Journal of the National Cancer Institute. - Oxford University Press. - 0027-8874. ; 96:4, s. 280-293
-
Tidskriftsartikel (refereegranskat)abstract
- Background: The appropriate management of women with minor cytologic lesions in their cervix is unclear. We performed a meta-analysis to assess the accuracy of human papillomavirus (HPV) DNA testing as an alternative to repeat cytology in women who had equivocal results on a previous Pap smear. Methods: Data were extracted from articles published between 1992 and 2002 that contained results of virologic and cytologic testing followed by colposcopically directed biopsy in women with an index smear showing atypical cells of undetermined significance (ASCUS). Fifteen studies were identified in which HPV triage and the histologic outcome (presence or absence of a cervical intra-epithelial neoplasia of grade 11 or worse CIN2+) was documented. Nine, seven, and two studies also documented the accuracy of repeat cytology when the cutoff for abnormal cytology was set at a threshold of ASCUS or worse, low-grade squamous intraepithelial lesion (LSIL) or worse, or high-grade squamous intraepithelial lesion (HSIL) or worse, respectively. Random-effects models were used for pooling of accuracy parameters in case of interstudy heterogeneity. Differences in accuracy were assessed by pooling the ratio of the sensitivity (or specificity) of HPV testing to that of repeat cytology. Results: The sensitivity and specificity were 84.4% (95% confidence interval CI = 77.6% to 91.1%) and 72.9% (95% CI = 62.5% to 83.3%), respectively, for HPV testing overall and 94.8% (95% CI = 92.7% to 96.9%) and 67.3% (95% CI = 58.2% to 76.4%), respectively, for HPV testing in the eight studies that used the Hybrid Capture 11 assay. Sensitivity and specificity of repeat cytology at a threshold for abnormal cytology of ASCUS or worse was 81.8% (95% CI = 73.5% to 84.3%) and 57.6% (95% CI = 49.5% to 65.7%), respectively. Repeat cytology that used higher cytologic thresholds yielded substantially lower sensitivity but higher specificity than triage with the Hybrid Capture 11 assay. The ratio of the sensitivity of the Hybrid Capture 11 assay to that of repeat cytology at a threshold of ASCUS or worse pooled from the four studies that used both triage tests was 1.16 (95% CI = 1.04 to 1.29). The specificity ratio was not statistically different from unity. Conclusion: The published literature indicates that the Hybrid Capture 11 assay has improved accuracy (higher sensitivity, similar specificity) than the repeat Pap smear using the threshold of ASCUS for an outcome of CIN2+ among women with equivocal cytologic results. The sensitivity of triage at higher cytologic cutoffs is poor.
|
|
| 5. |
- Davies, P, et al.
(författare)
-
A report on the current status of European research on the use of human papillomavirus testing for primary cervical cancer screening
- 2006
-
Ingår i: International Journal of Cancer. - Wiley-Liss. - 0020-7136. ; 118:4, s. 791-796
-
Forskningsöversikt (refereegranskat)abstract
- Cervical cancer remains a significant public health concern, both at a global and a European level. A number of new technologies such as diagnostic tests for human papillomavirus (HPV) have a potential to assist with the reduction of this disease. However, both the efficacy and the cost-effectiveness of these new technologies must be established in properly designed trials before they can be implemented within national public health programs. Our study reviews the randomized controlled trials that are currently being conducted in Europe to establish the performance of HPV testing as a primary cervical cancer screening test. (c) 2005 Wiley-Liss, Inc.
|
|
| 6. |
- Dillner, Joakim, et al.
(författare)
-
Monitoring of human papillomavirus vaccination.
- 2011
-
Ingår i: Clinical and experimental immunology. - 1365-2249. ; Dec, s. 17-25
-
Tidskriftsartikel (refereegranskat)abstract
- Persistent infection with oncogenic human papillomavirus (HPV) is a necessary causal factor in the development of cervical cancer. Moreover, HPV, predominately type 16 and to a lesser degree type 18, is linked causally to varying proportions of other anogenital cancers (vulva, vagina, penis, anus) as well as cancers elsewhere in the body (oropharynx, larynx, conjunctiva). HPV types 6 and 11 cause most of genital warts and recurrent respiratory papillomatosis. Effective prophylactic vaccines have been developed. In this review, we address briefly the immunological aspects of HPV infection and the results of HPV vaccination trials. Internationally standardized monitoring and evaluation of prophylactic HPV vaccination programmes will be essential for arriving at the most cost-effective strategies for cancer control.
|
|
| 7. |
|
|
