Performance of a 7-Type HPV mRNA Test in Triage of HPV DNA Primary Screen Positive Women Compared to Liquid-Based Cytology
Background: A plethora of data supports HPV-based screening to be the preferred strategy for cervical cancer prevention. The shift to a more sensitive first-line test brings the need of effective triage up for discussion. Currently, most algorithms apply cytology as a triage of HPV-DNA positive wome...
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ftdoajarticles:oai:doaj.org/article:dc5bc32b24a447d49ae9597ea9449389 2023-07-23T04:20:53+02:00 Performance of a 7-Type HPV mRNA Test in Triage of HPV DNA Primary Screen Positive Women Compared to Liquid-Based Cytology Sveinung Wergeland Sørbye Bente Marie Falang Mona Antonsen 2023-03-01T00:00:00Z https://doi.org/10.3390/jmp4020008 https://doaj.org/article/dc5bc32b24a447d49ae9597ea9449389 EN eng MDPI AG https://www.mdpi.com/2673-5261/4/2/8 https://doaj.org/toc/2673-5261 doi:10.3390/jmp4020008 2673-5261 https://doaj.org/article/dc5bc32b24a447d49ae9597ea9449389 Journal of Molecular Pathology, Vol 4, Iss 8, Pp 69-80 (2023) HPV-DNA primary screening HPV-mRNA biomarker triage liquid-based cytology Pathology RB1-214 article 2023 ftdoajarticles https://doi.org/10.3390/jmp4020008 2023-07-02T00:37:59Z Background: A plethora of data supports HPV-based screening to be the preferred strategy for cervical cancer prevention. The shift to a more sensitive first-line test brings the need of effective triage up for discussion. Currently, most algorithms apply cytology as a triage of HPV-DNA positive women. This study compared the performance of a 7-type HPV-mRNA test to cytology. Methods: From 1 January 2019 until 31 December 2021, cervical samples from 58,029 women were examined at the University Hospital of North Norway. A total of 30.5% (17,684/58,029) fulfilled the criteria for HPV-DNA primary screening. All positive samples were triaged by cytology and followed-up according to national guidelines through 2022. Additionally, a 7-type HPV-mRNA test was applied. The study endpoint was a histologically confirmed high-grade lesion (CIN2+). Results: A total of 5.6% (990/17,684) had positive HPV-DNA test, 97.2% (962/990) with valid HPV-mRNA results. A total of 55.5% (534/962) had abnormal cytology (ASC-US+), and 35.1% (338/962) had a positive HPV-mRNA test. A total of 13.9% (134/962) had CIN2+. The sensitivity (CIN2+) of cytology versus the HPV-mRNA test was 76.1% (102/134) versus 73.1% (98/134), p = 0.67. The specificity was 47.8% (396/828) versus 71.0% (588/624), p < 0.001. PPV was 19.1% (102/534) and 29.0% (98/338), p < 0.001, respectively. The number of colposcopies per CIN2+ detected by cytology and HPV-mRNA test was 5.2 and 3.1. Conclusion: The 7-type HPV mRNA test was significantly more specific than cervical cytology in a triage of HPV-DNA positive women. Using this biomarker as the threshold for colposcopy may better balance the benefits and harms of screening. Article in Journal/Newspaper North Norway Directory of Open Access Journals: DOAJ Articles Norway Journal of Molecular Pathology 4 2 69 80 |
institution |
Open Polar |
collection |
Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
HPV-DNA primary screening HPV-mRNA biomarker triage liquid-based cytology Pathology RB1-214 |
spellingShingle |
HPV-DNA primary screening HPV-mRNA biomarker triage liquid-based cytology Pathology RB1-214 Sveinung Wergeland Sørbye Bente Marie Falang Mona Antonsen Performance of a 7-Type HPV mRNA Test in Triage of HPV DNA Primary Screen Positive Women Compared to Liquid-Based Cytology |
topic_facet |
HPV-DNA primary screening HPV-mRNA biomarker triage liquid-based cytology Pathology RB1-214 |
description |
Background: A plethora of data supports HPV-based screening to be the preferred strategy for cervical cancer prevention. The shift to a more sensitive first-line test brings the need of effective triage up for discussion. Currently, most algorithms apply cytology as a triage of HPV-DNA positive women. This study compared the performance of a 7-type HPV-mRNA test to cytology. Methods: From 1 January 2019 until 31 December 2021, cervical samples from 58,029 women were examined at the University Hospital of North Norway. A total of 30.5% (17,684/58,029) fulfilled the criteria for HPV-DNA primary screening. All positive samples were triaged by cytology and followed-up according to national guidelines through 2022. Additionally, a 7-type HPV-mRNA test was applied. The study endpoint was a histologically confirmed high-grade lesion (CIN2+). Results: A total of 5.6% (990/17,684) had positive HPV-DNA test, 97.2% (962/990) with valid HPV-mRNA results. A total of 55.5% (534/962) had abnormal cytology (ASC-US+), and 35.1% (338/962) had a positive HPV-mRNA test. A total of 13.9% (134/962) had CIN2+. The sensitivity (CIN2+) of cytology versus the HPV-mRNA test was 76.1% (102/134) versus 73.1% (98/134), p = 0.67. The specificity was 47.8% (396/828) versus 71.0% (588/624), p < 0.001. PPV was 19.1% (102/534) and 29.0% (98/338), p < 0.001, respectively. The number of colposcopies per CIN2+ detected by cytology and HPV-mRNA test was 5.2 and 3.1. Conclusion: The 7-type HPV mRNA test was significantly more specific than cervical cytology in a triage of HPV-DNA positive women. Using this biomarker as the threshold for colposcopy may better balance the benefits and harms of screening. |
format |
Article in Journal/Newspaper |
author |
Sveinung Wergeland Sørbye Bente Marie Falang Mona Antonsen |
author_facet |
Sveinung Wergeland Sørbye Bente Marie Falang Mona Antonsen |
author_sort |
Sveinung Wergeland Sørbye |
title |
Performance of a 7-Type HPV mRNA Test in Triage of HPV DNA Primary Screen Positive Women Compared to Liquid-Based Cytology |
title_short |
Performance of a 7-Type HPV mRNA Test in Triage of HPV DNA Primary Screen Positive Women Compared to Liquid-Based Cytology |
title_full |
Performance of a 7-Type HPV mRNA Test in Triage of HPV DNA Primary Screen Positive Women Compared to Liquid-Based Cytology |
title_fullStr |
Performance of a 7-Type HPV mRNA Test in Triage of HPV DNA Primary Screen Positive Women Compared to Liquid-Based Cytology |
title_full_unstemmed |
Performance of a 7-Type HPV mRNA Test in Triage of HPV DNA Primary Screen Positive Women Compared to Liquid-Based Cytology |
title_sort |
performance of a 7-type hpv mrna test in triage of hpv dna primary screen positive women compared to liquid-based cytology |
publisher |
MDPI AG |
publishDate |
2023 |
url |
https://doi.org/10.3390/jmp4020008 https://doaj.org/article/dc5bc32b24a447d49ae9597ea9449389 |
geographic |
Norway |
geographic_facet |
Norway |
genre |
North Norway |
genre_facet |
North Norway |
op_source |
Journal of Molecular Pathology, Vol 4, Iss 8, Pp 69-80 (2023) |
op_relation |
https://www.mdpi.com/2673-5261/4/2/8 https://doaj.org/toc/2673-5261 doi:10.3390/jmp4020008 2673-5261 https://doaj.org/article/dc5bc32b24a447d49ae9597ea9449389 |
op_doi |
https://doi.org/10.3390/jmp4020008 |
container_title |
Journal of Molecular Pathology |
container_volume |
4 |
container_issue |
2 |
container_start_page |
69 |
op_container_end_page |
80 |
_version_ |
1772185697847869440 |