Screening with a primary human papillomavirus test does not increase detection of cervical cancer and intraepithelial neoplasia 3

Laura Kotaniemi-Talonen; Ahti Anttila; Nea Malila; Jussi Tarkkanen; Pekka Laurila; Matti Hakama; Pekka Nieminen

doi:10.1016/j.ejca.2007.12.002

Screening with a primary human papillomavirus test does not increase detection of cervical cancer and intraepithelial neoplasia 3

Laura Kotaniemi-Talonen, Ahti Anttila, Nea Malila, Jussi Tarkkanen, Pekka Laurila, Matti Hakama, Pekka Nieminen

Research output: Contribution to journal › Article › Scientific › peer-review

49 Citations (Scopus)

Abstract

AIM: To determine cross-sectional validity of primary human papillomavirus (HPV) screening in comparison to cytological screening.

METHODS: During 2003-2004, 61,149 women were individually randomised to screening with a test for oncogenic HPV DNA or to conventional cytological screening within the Finnish cervical screening programme.

RESULTS: For HPV screening, cross-sectional relative sensitivity for cervical intraepithelial neoplasia (CIN) or cancer was 1.58 (95 % confidence interval 1.19-2.09) in comparison to cytology. At the level of CIN 3 or cancer no increase in relative sensitivity was observed. Cross-sectional specificity estimates for the screening arms were comparable, but the specificity of screening with sole HPV DNA test was clearly inferior.

CONCLUSIONS: Primary HPV screening with cytology triage finds more CIN lesions compared to conventional screening but mild lesions are overrepresented. This is likely to result in overdiagnosis since most mild lesions are regressive.

Original language	English
Pages (from-to)	565-71
Number of pages	7
Journal	EUROPEAN JOURNAL OF CANCER
Volume	44
Issue number	4
DOIs	https://doi.org/10.1016/j.ejca.2007.12.002
Publication status	Published - Mar 2008
Publication type	A1 Journal article-refereed

Keywords

Adult
Aged
Alphapapillomavirus/isolation & purification
Cervical Intraepithelial Neoplasia/diagnosis
Colposcopy/methods
Cross-Sectional Studies
Cytological Techniques/methods
DNA, Viral/isolation & purification
Female
Humans
Mass Screening/methods
Middle Aged
Papillomavirus Infections/diagnosis
Sensitivity and Specificity
Uterine Cervical Neoplasms/diagnosis
Vaginal Smears/methods

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.ejca.2007.12.002

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title = "Screening with a primary human papillomavirus test does not increase detection of cervical cancer and intraepithelial neoplasia 3",

abstract = "AIM: To determine cross-sectional validity of primary human papillomavirus (HPV) screening in comparison to cytological screening.METHODS: During 2003-2004, 61,149 women were individually randomised to screening with a test for oncogenic HPV DNA or to conventional cytological screening within the Finnish cervical screening programme.RESULTS: For HPV screening, cross-sectional relative sensitivity for cervical intraepithelial neoplasia (CIN) or cancer was 1.58 (95 % confidence interval 1.19-2.09) in comparison to cytology. At the level of CIN 3 or cancer no increase in relative sensitivity was observed. Cross-sectional specificity estimates for the screening arms were comparable, but the specificity of screening with sole HPV DNA test was clearly inferior.CONCLUSIONS: Primary HPV screening with cytology triage finds more CIN lesions compared to conventional screening but mild lesions are overrepresented. This is likely to result in overdiagnosis since most mild lesions are regressive.",

keywords = "Adult, Aged, Alphapapillomavirus/isolation & purification, Cervical Intraepithelial Neoplasia/diagnosis, Colposcopy/methods, Cross-Sectional Studies, Cytological Techniques/methods, DNA, Viral/isolation & purification, Female, Humans, Mass Screening/methods, Middle Aged, Papillomavirus Infections/diagnosis, Sensitivity and Specificity, Uterine Cervical Neoplasms/diagnosis, Vaginal Smears/methods",

author = "Laura Kotaniemi-Talonen and Ahti Anttila and Nea Malila and Jussi Tarkkanen and Pekka Laurila and Matti Hakama and Pekka Nieminen",

year = "2008",

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doi = "10.1016/j.ejca.2007.12.002",

language = "English",

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pages = "565--71",

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issn = "0959-8049",

publisher = "Elsevier",

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T1 - Screening with a primary human papillomavirus test does not increase detection of cervical cancer and intraepithelial neoplasia 3

AU - Kotaniemi-Talonen, Laura

AU - Anttila, Ahti

AU - Malila, Nea

AU - Tarkkanen, Jussi

AU - Laurila, Pekka

AU - Hakama, Matti

AU - Nieminen, Pekka

PY - 2008/3

Y1 - 2008/3

N2 - AIM: To determine cross-sectional validity of primary human papillomavirus (HPV) screening in comparison to cytological screening.METHODS: During 2003-2004, 61,149 women were individually randomised to screening with a test for oncogenic HPV DNA or to conventional cytological screening within the Finnish cervical screening programme.RESULTS: For HPV screening, cross-sectional relative sensitivity for cervical intraepithelial neoplasia (CIN) or cancer was 1.58 (95 % confidence interval 1.19-2.09) in comparison to cytology. At the level of CIN 3 or cancer no increase in relative sensitivity was observed. Cross-sectional specificity estimates for the screening arms were comparable, but the specificity of screening with sole HPV DNA test was clearly inferior.CONCLUSIONS: Primary HPV screening with cytology triage finds more CIN lesions compared to conventional screening but mild lesions are overrepresented. This is likely to result in overdiagnosis since most mild lesions are regressive.

AB - AIM: To determine cross-sectional validity of primary human papillomavirus (HPV) screening in comparison to cytological screening.METHODS: During 2003-2004, 61,149 women were individually randomised to screening with a test for oncogenic HPV DNA or to conventional cytological screening within the Finnish cervical screening programme.RESULTS: For HPV screening, cross-sectional relative sensitivity for cervical intraepithelial neoplasia (CIN) or cancer was 1.58 (95 % confidence interval 1.19-2.09) in comparison to cytology. At the level of CIN 3 or cancer no increase in relative sensitivity was observed. Cross-sectional specificity estimates for the screening arms were comparable, but the specificity of screening with sole HPV DNA test was clearly inferior.CONCLUSIONS: Primary HPV screening with cytology triage finds more CIN lesions compared to conventional screening but mild lesions are overrepresented. This is likely to result in overdiagnosis since most mild lesions are regressive.

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KW - Cervical Intraepithelial Neoplasia/diagnosis

KW - Colposcopy/methods

KW - Cross-Sectional Studies

KW - Cytological Techniques/methods

KW - DNA, Viral/isolation & purification

KW - Female

KW - Humans

KW - Mass Screening/methods

KW - Middle Aged

KW - Papillomavirus Infections/diagnosis

KW - Sensitivity and Specificity

KW - Uterine Cervical Neoplasms/diagnosis

KW - Vaginal Smears/methods

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DO - 10.1016/j.ejca.2007.12.002

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JO - EUROPEAN JOURNAL OF CANCER

JF - EUROPEAN JOURNAL OF CANCER

IS - 4

ER -

Screening with a primary human papillomavirus test does not increase detection of cervical cancer and intraepithelial neoplasia 3

Abstract

Keywords

UN SDGs

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