TY - JOUR
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.
KW - Adult
KW - Aged
KW - Alphapapillomavirus/isolation & purification
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
U2 - 10.1016/j.ejca.2007.12.002
DO - 10.1016/j.ejca.2007.12.002
M3 - Article
C2 - 18248809
SN - 0959-8049
VL - 44
SP - 565
EP - 571
JO - EUROPEAN JOURNAL OF CANCER
JF - EUROPEAN JOURNAL OF CANCER
IS - 4
ER -
