© 2000 by Oxford University Press
Journal of the National Cancer Institute, Vol. 92, No. 10, 818-825,
May 17, 2000
© 2000 Oxford University Press
Human Papillomavirus DNA Testing for Cervical Cancer Screening in Low-Resource Settings
Affiliations of authors: L. Kuhn, Gertrude H. Sergievsky Center, College of Physicians and Surgeons, and Division of Epidemiology, Joseph L. Mailman School of Public Health, Columbia University, New York, NY; L. Denny, Department of Obstetrics and Gynecology, University of Cape Town, South Africa; A. Pollack, AVSC International, New York, NY; A. Lorincz, Digene Corporation, Silver Spring, MD; R. M. Richart, T. C. Wright, Department of Pathology, College of Physicians and Surgeons of Columbia University.
Correspondence to: Thomas C. Wright, M.D., Department of Pathology, College of Physicians and Surgeons of Columbia University, Rm. 16-404, 630 W. 168th St., New York, NY 10032 (e-mail: tcw1{at}columbia.edu).
Background: In many low-resource settings, there are barriers to cytologic screening for cervical cancer. This study evaluates human papillomavirus (HPV) DNA testing as an alternative screening method. Methods: Cervical samples from 2944 previously unscreened South African women aged 35–65 years were tested for high-risk types of HPV with the use of the Hybrid Capture I (HCI) assay. Women also had a Pap smear, direct visual inspection of the cervix, and CervicographyTM. Women positive on any screening test were referred for colposcopy. Samples from women with biopsy-confirmed, low-grade squamous intraepithelial lesions (SILs) (n = 95), high-grade SILs (n = 74), or invasive cervical cancer (n = 12) and a random sample of women with no cervical disease (n = 243) were retested for HPV DNA with the use of the more sensitive Hybrid Capture II (HCII) assay. All P values are two-sided. Results: High-risk HPV DNA was detected in 73.3% and 88.4% of 86 women with high-grade SIL or invasive cancer and in 12.2% of 2680 and 18.1% of 243 women without evidence of cervical disease, with the use of the HCI and HCII assays, respectively. HPV DNA testing with the HCII assay was more sensitive than cytology for detecting high-grade SIL and invasive cancer (McNemar's test, P = .04), and testing with the HCI assay was of equivalent sensitivity (P = .61). Cytology had a statistically significantly better specificity (96.8%) than either the HCI assay (87.8%) or the HCII assay (81.9%) (P<.01). Receiver operating characteristic curves identified test cutoff values that allow HPV DNA testing to identify 57% of women with high-grade SIL or cancer, while classifying less than 5% of women with no cervical disease as HPV DNA positive. Conclusions: HPV DNA testing has a sensitivity equivalent to, or better than, that of cytology. Since HPV DNA testing programs may be easier to implement than cytologic screening, HPV testing should be considered for primary cervical cancer screening in low-resource settings.
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  A. Balasubramanian, J. Hughes, C. Mao, R. Ridder, M. Herkert, N. B. Kiviat, and L. A. Koutsky Evaluation of an ELISA for p16INK4a as a Screening Test for Cervical Cancer Cancer Epidemiol. Biomarkers Prev., November 1, 2009; 18(11): 3008 - 3017. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C Horvath, G Boulet, S Sahebali, J Bogers, C Depuydt, A Vereecken, T Vermeulen, and D Vanden Broeck Effects of fixation on RNA integrity in a liquid-based cervical cytology setting J. Clin. Pathol., January 1, 2008; 61(1): 132 - 137. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. E. Schutzbank, C. Jarvis, N. Kahmann, K. Lopez, M. Weimer, and A. Yount Detection of High-Risk Papillomavirus DNA with Commercial Invader-Technology-Based Analyte-Specific Reagents following Automated Extraction of DNA from Cervical Brushings in ThinPrep Media J. Clin. Microbiol., December 1, 2007; 45(12): 4067 - 4069. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M.-H. Mayrand, E. Duarte-Franco, I. Rodrigues, S. D. Walter, J. Hanley, A. Ferenczy, S. Ratnam, F. Coutlee, E. L. Franco, and the Canadian Cervical Cancer Screening Trial Study Human Papillomavirus DNA versus Papanicolaou Screening Tests for Cervical Cancer N. Engl. J. Med., October 18, 2007; 357(16): 1579 - 1588. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. Ogilvie MD MSc, M. Krajden MD, J. Maginley RN, J. Isaac-Renton MD, G. Hislop MDCM MSc, R. Elwood-Martin MD, C. Sherlock MB, D. Taylor BSN, and M. Rekart MD Feasibility of self-collection of specimens for human papillomavirus testing in hard-to-reach women Can. Med. Assoc. J., August 28, 2007; 177(5): 480 - 483. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. Ronco, N. Segnan, P. Giorgi-Rossi, M. Zappa, G. P. Casadei, F. Carozzi, P. D. Palma, A. Del Mistro, S. Folicaldi, A. Gillio-Tos, et al. Human papillomavirus testing and liquid-based cytology: results at recruitment from the new technologies for cervical cancer randomized controlled trial. J Natl Cancer Inst, June 7, 2006; 98(11): 765 - 774. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. J. Goldie, L. Gaffikin, J. D. Goldhaber-Fiebert, A. Gordillo-Tobar, C. Levin, C. Mahe, T. C. Wright, and the Alliance for Cervical Cancer Prevention Cost W Cost-Effectiveness of Cervical-Cancer Screening in Five Developing Countries N. Engl. J. Med., November 17, 2005; 353(20): 2158 - 2168. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C Carrilho, L Cirnes, M Alberto, L Buane, N Mendes, and L David Distribution of HPV infection and tumour markers in cervical intraepithelial neoplasia from cone biopsies of Mozambican women J. Clin. Pathol., January 1, 2005; 58(1): 61 - 68. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S.-M. Kulmala, S. Syrjanen, I. Shabalova, N. Petrovichev, V. Kozachenko, J. Podistov, O. Ivanchenko, S. Zakharenko, R. Nerovjna, L. Kljukina, et al. Human Papillomavirus Testing with the Hybrid Capture 2 Assay and PCR as Screening Tools J. Clin. Microbiol., June 1, 2004; 42(6): 2470 - 2475. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. L. Franco Chapter 13: Primary Screening of Cervical Cancer With Human Papillomavirus Tests J Natl Cancer Inst Monographs, June 1, 2003; 2003(31): 89 - 96. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. Saslow, C. D. Runowicz, D. Solomon, A.-B. Moscicki, R. A. Smith, H. J. Eyre, and C. Cohen American Cancer Society Guideline for the Early Detection of Cervical Neoplasia and Cancer CA Cancer J Clin, November 1, 2002; 52(6): 342 - 362. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. S. Mandelblatt, W. F. Lawrence, L. Gaffikin, K. K. Limpahayom, P. Lumbiganon, S. Warakamin, J. King, B. Yi, P. Ringers, and P. D. Blumenthal Costs and Benefits of Different Strategies to Screen for Cervical Cancer in Less-Developed Countries J Natl Cancer Inst, October 2, 2002; 94(19): 1469 - 1483. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. S. Mandelblatt, W. F. Lawrence, S. M. Womack, D. Jacobson, B. Yi, Y.-t. Hwang, K. Gold, J. Barter, and K. Shah Benefits and Costs of Using HPV Testing to Screen for Cervical Cancer JAMA, May 8, 2002; 287(18): 2372 - 2381. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Bayo, F X. Bosch, S. de Sanjose, N. Munoz, A. L. Combita, P. Coursaget, M. Diaz, A. Dolo, A. J. van den Brule, and C. J. Meijer Risk factors of invasive cervical cancer in Mali Int. J. Epidemiol., February 1, 2002; 31(1): 202 - 209. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. J. Goldie, L. Kuhn, L. Denny, A. Pollack, and T. C. Wright Policy Analysis of Cervical Cancer Screening Strategies in Low-Resource Settings: Clinical Benefits and Cost-effectiveness JAMA, June 27, 2001; 285(24): 3107 - 3115. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F X Bosch, T Rohan, A Schneider, I Frazer, H Pfister, X Castellsague, S de Sanjose, V Moreno, L M Puig-Tintore, P G Smith, et al. Papillomavirus research update: highlights of the Barcelona HPV 2000 international papillomavirus conference J. Clin. Pathol., March 1, 2001; 54(3): 163 - 175. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. C. Wright Jr., S. J. Goldie, J. M. Cain, and M. K. Howett Screening for Cervical Cancer Science, December 1, 2000; 290(5497): 1651a - 1651. [Full Text]
|
|