Document Detail


Comparison of measurements of human papillomavirus persistence for postcolposcopic surveillance for cervical precancerous lesions.
MedLine Citation:
PMID:  20615884     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Following guidelines, women evaluated by colposcopy, but not found to have a precancerous lesion, could be tested again at 12 months for carcinogenic human papillomavirus (HPV). Compared with pooled-probe testing, measuring HPV genotype-specific persistence might better predict subsequent grade 3 cervical intraepithelial neoplasia (CIN3).
METHODS: For women enrolled in the immediate colposcopy arm of the Atypical squamous cells of undetermined significance (ASCUS) and Low-grade squamous intraepithelial lesion (LSIL) Triage Study (ALTS), who underwent enrollment colposcopy but were without prevalently detected CIN2 or worse (CIN2+; n = 671), we compared 1-year HPV persistence, as measured by a pooled HPV genotype test (hybrid capture 2; hc2) versus a research PCR HPV genotyping test (line blot assay; LBA) as predictors of "missed prevalent" or possibly incident CIN3 diagnosed between 12 and 24 months.
RESULTS: Thirty-two (4.8%) women were diagnosed with subsequent CIN3. Testing repeatedly hc2-positive (hc2+) was more common (49.0%) than genotype-specific persistence as detected by LBA (30.3%, P < 0.01). Although absolute risks of CIN3 following repeat hc2+ or genotype-specific persistence were similar (8.8% versus 8.4%, P = 0.86), repeat hc2+ was more sensitive for identifying CIN3 than genotype-specific persistence (90.6% versus 53.1%, P < 0.01). Among 329 women repeatedly hc2+, women with persistent HPV16 were at higher risk of CIN3 than non-HPV16-persistent women (23.1% versus 7.0%, P < 0.01).
CONCLUSIONS: For postcolposcopy management, 1-year HPV persistence as measured by hc2 would recall more women but was more sensitive and similarly predictive for CIN3 in the following year than detection of genotype-specific persistence by LBA.
IMPACT: Although find little utility for measuring type-specific persistence, testing for persistent HPV16 might be clinically useful.
Authors:
Julia C Gage; Mark Schiffman; Diane Solomon; Cosette M Wheeler; Philip E Castle
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Publication Detail:
Type:  Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, N.I.H., Extramural; Research Support, N.I.H., Intramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology     Volume:  19     ISSN:  1538-7755     ISO Abbreviation:  Cancer Epidemiol. Biomarkers Prev.     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-07-09     Completed Date:  2010-10-28     Revised Date:  2014-01-14    
Medline Journal Info:
Nlm Unique ID:  9200608     Medline TA:  Cancer Epidemiol Biomarkers Prev     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1668-74     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Carcinoma, Squamous Cell / diagnosis,  pathology,  virology*
Cervical Intraepithelial Neoplasia / diagnosis,  pathology,  virology*
Cohort Studies
Colposcopy
Female
Genotype
Humans
Papillomaviridae / genetics,  isolation & purification*
Papillomavirus Infections / diagnosis,  pathology,  virology*
Risk Factors
Uterine Cervical Neoplasms / diagnosis,  genetics,  virology*
Young Adult
Grant Support
ID/Acronym/Agency:
CN-55105/CN/NCI NIH HHS; CN-55153/CN/NCI NIH HHS; CN-55154/CN/NCI NIH HHS; CN-55155/CN/NCI NIH HHS; CN-55156/CN/NCI NIH HHS; CN-55157/CN/NCI NIH HHS; CN-55158/CN/NCI NIH HHS; CN-55159/CN/NCI NIH HHS; N01 CN055105/CN/NCI NIH HHS; N01 CN055153/CN/NCI NIH HHS; N01 CN055154/CN/NCI NIH HHS; N01 CN055155/CN/NCI NIH HHS; N01 CN055156/CN/NCI NIH HHS; N01 CN055157/CN/NCI NIH HHS; N01 CN055158/CN/NCI NIH HHS; N01 CN055159/CN/NCI NIH HHS; Z01 CP010124-13/CP/NCI NIH HHS; Z99 CA999999/CA/NCI NIH HHS
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