Effectiveness of novel, lower cost molecular human papillomavirus-based tests for cervical cancer screening in rural china

被引:34
|
作者
Valdez, Melissa [1 ]
Jeronimo, Jose [1 ]
Bansil, Pooja [1 ]
Qiao, You-Lin [2 ,3 ]
Zhao, Fang-Hui [2 ,3 ]
Chen, Wen [2 ,3 ]
Zhang, Xun [2 ,3 ]
Kang, Le-Ni [2 ,3 ]
Paul, Proma [1 ]
Bai, Ping [2 ,3 ]
Peck, Roger [1 ]
Li, Jing [2 ,3 ]
Chen, Feng [2 ,3 ]
Stoler, Mark H. [4 ]
Castle, Philip E. [5 ,6 ]
机构
[1] PATH, Seattle, WA USA
[2] Chinese Acad Med Sci, Canc Inst & Hosp, Beijing 100730, Peoples R China
[3] Peking Union Med Coll, Beijing 100021, Peoples R China
[4] Univ Virginia, Dept Pathol, Charlottesville, VA 22903 USA
[5] Global Coalit Cerv Canc, Chestertown, MD USA
[6] Albert Einstein Coll Med, Dept Epidemiol & Populat Hlth, Bronx, NY 10467 USA
基金
比尔及梅琳达.盖茨基金会;
关键词
E6; HPV; cervical intraepithelial neoplasia; cervical cancer screening; RISK; NEOPLASIA; PREVENTION; CYTOLOGY; DNA; PRECANCER; DIAGNOSIS; REGIONS; WOMEN;
D O I
10.1002/ijc.29877
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
This study examined the efficacy of the OncoE6(TM) Cervical Test, careHPV(TM) and visual inspection with acetic acid (VIA) in identifying women at risk for cervical cancer and their capability to detect incident cervical precancer and cancer at 1-year follow-up. In a population of 7,543 women living in rural China, women provided a self-collected and two clinician-collected specimens and underwent VIA. All screen positive women for any of the tests, a -10% random sample of test-negative women that underwent colposcopy at baseline, and an additional -10% random sample of test-negative women who did not undergo colposcopy at baseline (n53,290) were recruited. 2,904 women were rescreened 1 year later using the same tests, colposcopic referral criteria, and procedures. Sensitivities of baseline tests to detect 1-year cumulative cervical intraepithelial neoplasia Grade 3 or cancer (CIN3+) were 96.5% and 81.6% for careHPV TM on clinician-collected and self-collected specimens, respectively, and 54.4% for OncoE6 TM test. The OncoE6 TM test was very specific (99.1%) and had the greatest positive predictive value (PPV; 47.7%) for CIN3+. Baseline and 1-year follow-up cervical specimens testing HPV DNA positive was sensitive (88.0%) but poorly predictive (5.5-6.0%) of incident CIN2+, whereas testing repeat HPV16, 18 and 45 E6 positive identified only 24.0% of incident CIN2+ but had a predictive value of 33.3%. This study highlights the different utility of HPV DNA and E6 tests, the former as a screening and the latter as a diagnostic test, for detection of cervical precancer and cancer.
引用
收藏
页码:1453 / 1461
页数:9
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