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1.
Int J Environ Res Public Health ; 19(8)2022 04 12.
Article in English | MEDLINE | ID: covidwho-1809860

ABSTRACT

BACKGROUND: HPV primary screening has shown effectiveness for cancer prevention; however, gynaecological examination is considered uncomfortable. Self-sampling methods increase the acceptance of screening. The aim of this study is to compare the sensitivity and specificity of clinician sampling versus vaginal and urine self-sampling for HPV diagnosis. METHODS: A diagnostic test study was conducted in a rural parish of Cuenca, Ecuador. A total of 120 women participated. Each participant self-collected urine and vaginal samples and underwent clinician sampling for HPV testing. The latter was considered as the golden standard. All three samples were processed with the same amplification and hybridization protocol for HPV detection (Hybribio) following the manufacturer's instructions. RESULTS: Characteristics of the participants were: median age 35 years; 40.8% married; 46.7% had a primary level of education; and median age of sexual onset, 17.6 years. The prevalence of any type of HPV with clinician sampling was 15.0%, 17.5% with urine sampling and 18.3% with vaginal self-sampling. Self-sampling sensitivity reached 94.4% (IC 74.2-99.9), and specificity 92.1% (IC 85.2-95.9). Urine sampling had a sensitivity of 88.8% (IC 67.2, 96.9), and specificity 94.1% (IC 67.2-96.9). The negative predictive value was 98.9% (IC 94.2-99.8) for vaginal self-sampling and 97.6% (IC 92.6-99.4) for urine sampling. CONCLUSIONS: This study shows that vaginal and urine self-sampling methods have similar sensitivity and specificity compared with clinician sampling for the diagnosis of HPV. The correlation between HPV genotypes among the three tests is satisfactory.


Subject(s)
Cervical Intraepithelial Neoplasia , Papillomavirus Infections , Uterine Cervical Neoplasms , Adolescent , Adult , Cervical Intraepithelial Neoplasia/diagnosis , Diagnostic Tests, Routine , Early Detection of Cancer/methods , Ecuador/epidemiology , Female , Humans , Male , Papillomaviridae/genetics , Papillomavirus Infections/diagnosis , Papillomavirus Infections/epidemiology , Rural Population , Sensitivity and Specificity , Specimen Handling/methods , Uterine Cervical Neoplasms/prevention & control , Vaginal Smears
2.
Cytopathology ; 33(3): 350-356, 2022 05.
Article in English | MEDLINE | ID: covidwho-1577413

ABSTRACT

BACKGROUND: The coronavirus pandemic has had a profound impact on the cervical screening programme in Wales for the eligible women, sample takers, and laboratory and colposcopy services. AIMS: To explore what changes due to the pandemic have adversely affected screening outcomes in Wales and what lessons can be learned to improve cervical screening in Wales and elsewhere. METHODS: A review of the screening performance in 2020 and the first quarter of 2021 in Wales as well as a comparison with other cervical screening programme responses to the pandemic. RESULTS: A 3 month pause of screening together with a change in a variety of working practices, including social distancing, use of personal protective equipment, use of virtual meetings, and home working have been implemented. The combination of a pause to the issuing of invitations, plus reduced services in primary and secondary care, together with population lockdown, have contributed to longer waiting times for colposcopy and potentially delayed cancer diagnoses. Some programme changes which were being evaluated prior to the pandemic could be developed now to mitigate the impact of the pandemic such as improved information, increased screening intervals for human papillomavirus-based screening programmes, and home working for call and recall staff. CONCLUSIONS: Despite a considerable short-term interruption to the cervical screening programme, some changes introduced as a result of the coronavirus pandemic could provide key lessons learnt for improvement for cervical cancer prevention services.


Subject(s)
Cervical Intraepithelial Neoplasia , Coronavirus Infections , Coronavirus , Papillomavirus Infections , Uterine Cervical Neoplasms , Cervical Intraepithelial Neoplasia/diagnosis , Colposcopy , Early Detection of Cancer , Female , Humans , Mass Screening , Pandemics/prevention & control , Papillomavirus Infections/diagnosis , Papillomavirus Infections/epidemiology , Papillomavirus Infections/prevention & control , Pregnancy , Uterine Cervical Neoplasms/diagnosis , Uterine Cervical Neoplasms/epidemiology , Vaginal Smears
3.
Nihon Koshu Eisei Zasshi ; 68(11): 719-727, 2021 Dec 04.
Article in Japanese | MEDLINE | ID: covidwho-1554772

ABSTRACT

Objectives We investigated the participation and detection rates of cervical lesions in cervical screening non-attenders offered HPV (human papillomavirus) self-sampling with cytology triage.Methods From 2016 to 2018, HPV self-sampling was routinely offered as an option, along with cytology, to all non-attenders in Ebetsu City, Japan. The primary endpoints were ≥CIN2 and ≥CIN3 detection rates, and secondary endpoints were abnormal cytology rates and follow-up compliance.Results Overall, recall invitations were mailed to 6,116 non-attenders, with a response rate of 15.9% (cytology: 6.5%, HPV testing: 9.4%). Of the responders to undergo HPV self-sampling, 11.7% had a positive result and were referred to cytology triage. Moreover, ≥CIN2 and ≥CIN3 detection rates were 1.7% and 0.9%, respectively, in the HPV self-sampling group, and 1.0% and 0.8%, respectively, in the cytology group, showing no statistically significant differences. In those who underwent cytology triage following an HPV positive test, ≥CIN2 and ≥CIN3 detection rates were 23.8% and 11.9%, respectively, which was significantly higher than those who only underwent cytology alone.Conclusion HPV self-sampling followed by cytology triage is highly effective at detecting high grade disease in non-attenders. Thus, multi-municipality-based studies to standardize processes involving this method are warranted. Furthermore, HPV self-sampling could be a promising method for inviting non-attenders who have difficulty undergoing cervical screening in the COVID-19 pandemic era.


Subject(s)
COVID-19 , Cervical Intraepithelial Neoplasia , Papillomavirus Infections , Uterine Cervical Neoplasms , Cervical Intraepithelial Neoplasia/diagnosis , Early Detection of Cancer , Feasibility Studies , Female , Humans , Mass Screening , Pandemics , Papillomavirus Infections/diagnosis , SARS-CoV-2 , Triage , Uterine Cervical Neoplasms/diagnosis
4.
Nihon Koshu Eisei Zasshi ; 68(11): 719-727, 2021 Dec 04.
Article in Japanese | MEDLINE | ID: covidwho-1350538

ABSTRACT

Objectives We investigated the participation and detection rates of cervical lesions in cervical screening non-attenders offered HPV (human papillomavirus) self-sampling with cytology triage.Methods From 2016 to 2018, HPV self-sampling was routinely offered as an option, along with cytology, to all non-attenders in Ebetsu City, Japan. The primary endpoints were ≥CIN2 and ≥CIN3 detection rates, and secondary endpoints were abnormal cytology rates and follow-up compliance.Results Overall, recall invitations were mailed to 6,116 non-attenders, with a response rate of 15.9% (cytology: 6.5%, HPV testing: 9.4%). Of the responders to undergo HPV self-sampling, 11.7% had a positive result and were referred to cytology triage. Moreover, ≥CIN2 and ≥CIN3 detection rates were 1.7% and 0.9%, respectively, in the HPV self-sampling group, and 1.0% and 0.8%, respectively, in the cytology group, showing no statistically significant differences. In those who underwent cytology triage following an HPV positive test, ≥CIN2 and ≥CIN3 detection rates were 23.8% and 11.9%, respectively, which was significantly higher than those who only underwent cytology alone.Conclusion HPV self-sampling followed by cytology triage is highly effective at detecting high grade disease in non-attenders. Thus, multi-municipality-based studies to standardize processes involving this method are warranted. Furthermore, HPV self-sampling could be a promising method for inviting non-attenders who have difficulty undergoing cervical screening in the COVID-19 pandemic era.


Subject(s)
COVID-19 , Cervical Intraepithelial Neoplasia , Papillomavirus Infections , Uterine Cervical Neoplasms , Cervical Intraepithelial Neoplasia/diagnosis , Early Detection of Cancer , Feasibility Studies , Female , Humans , Mass Screening , Pandemics , Papillomavirus Infections/diagnosis , SARS-CoV-2 , Triage , Uterine Cervical Neoplasms/diagnosis
5.
PLoS One ; 16(7): e0253493, 2021.
Article in English | MEDLINE | ID: covidwho-1298079

ABSTRACT

OBJECTIVE: To validate the colposcopy indication proposed by the 2019 ASCCP Risk-Based Management Consensus Guidelines for abnormal cervical cancer screening tests (the 2019 ASCCP guidelines). METHODS: Clinical data of 1404 patients who underwent colposcopy in single center in China were reviewed. Based on history and current cervical screening (HPV & cytology), corresponding recommendations were given according to the 2019 ASCCP guidelines. The agreement and discrepancy of colposcopy indication were analyzed between the Chinese consensus and the 2019 ASCCP guidelines. RESULTS: Colposcopy indication was matched in about 80% patients. The left 20% were recommended with follow-up by the 2019 ASCCP guidelines. The discrepancy mainly focused on patients having a current result of HPV-positive NILM without unknown history. The ratio of observed CIN3+ in our database over estimated CIN3+ by the 2019 ASCCP guidelines was 6.2 (31/5). The ratio was even higher in patients with HPV16/18-positive NILM (7, 28/4), compared with those with other types of high-risk HPV-positive NILM (3, 3/1). The 2019 ASCCP guidelines had a relatively high sensitivity (83.1%), a low specificity (21.5%), a low positive predictive value (14.1%) and a high negative predictive value (89.1%) for prediction of CIN 3+. CONCLUSIONS: We could try to apply the 2019 ASCCP guidelines in Chinese population. The classification of HR-HPV was strongly recommended during risk assessment. For patients with HPV16/18 infection, colposcopy should be recommended. Perspective multi-center randomized controlled trial with reliable follow-up should be performed in the future to confirm the feasibility.


Subject(s)
Cervical Intraepithelial Neoplasia/diagnosis , Colposcopy/standards , Early Detection of Cancer/methods , Guidelines as Topic , Uterine Cervical Neoplasms/diagnosis , Adult , Cervical Intraepithelial Neoplasia/pathology , China , Female , Human papillomavirus 16/isolation & purification , Human papillomavirus 18/isolation & purification , Humans , Mass Screening/methods , Papillomavirus Infections/pathology , Retrospective Studies , Risk , Uterine Cervical Neoplasms/pathology
6.
Future Oncol ; 17(10): 1197-1207, 2021 Apr.
Article in English | MEDLINE | ID: covidwho-1112570

ABSTRACT

Aims: To evaluate the efficacy of TruScreen (TS01) for high-risk human papillomavirus (HR-HPV) women compared with other methods in reducing colposcopy referral rates in hospitals. Methods: A single-center, prospective, case-control study was conducted from December 2019 to June 2020. Results: Among 139 (46.2%) HR-HPV-positive patients, 58 were CIN1, 52 were CIN2-3 and 29 had cervical cancer (n = 29). The sensitivity and specificity of detecting CIN2+ by TS01, colposcopy and HPV16/18 testing were 96.3% and 46.4%, 85.2% and 40.5% and 59.3% and 74.1%, respectively. The highest sensitivity was 96.3% at HPV16/18 and TS01 (each positive results), and the highest specificity was 83.6% at HPV16/18 and TS01 (both positive) for CIN2+ compared with the other methods. Conclusion: TS01 is a noninvasive screening method and can be used to diagnose cervical lesions quickly. It is especially suitable as triage tool for HR-HPV-positive women facing SARS-CoV-2 exposure and infection risks in hospital.


Subject(s)
COVID-19/epidemiology , Cervical Intraepithelial Neoplasia/diagnosis , Early Detection of Cancer/methods , Papillomavirus Infections/complications , SARS-CoV-2 , Uterine Cervical Neoplasms/diagnosis , Adolescent , Adult , Aged , Aged, 80 and over , Colposcopy , Female , Humans , Middle Aged , Prospective Studies , Sensitivity and Specificity , Triage/methods , Young Adult
7.
Ginekol Pol ; 91(7): 428-431, 2020.
Article in English | MEDLINE | ID: covidwho-719820

ABSTRACT

The Polish Society of Gynecologists and Obstetricians and Polish Society of Colposcopy and Cervical Pathophysiology Interim Guidelines goal at aiding gynecologists in providing a cervical cancer prevention care during the evolving SARS-CoV-2 pan-demic. Presented guidelines were developed on a review of limited data and updated when new relevant publications were revealed. Timing for deferrals of diagnostic-therapeutic procedures were mostly covered in the guidelines. Also, a support for the existing Polish recommendations on abnormal screening results in a subject of minor and major screening abnor-malities terminology were given. The guidelines are obligatory for the specified COVID-19 pandemic period only and they might be changed depending on the new available evidence.


Subject(s)
Cervical Intraepithelial Neoplasia , Cervix Uteri/pathology , Colposcopy , Coronavirus Infections , Early Detection of Cancer , Pandemics , Pneumonia, Viral , Uterine Cervical Neoplasms , Betacoronavirus , COVID-19 , Cervical Intraepithelial Neoplasia/diagnosis , Cervical Intraepithelial Neoplasia/pathology , Colposcopy/methods , Colposcopy/standards , Communicable Disease Control/methods , Communicable Disease Control/organization & administration , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Diagnosis, Differential , Early Detection of Cancer/standards , Female , Humans , Pandemics/prevention & control , Patient Care Management/methods , Patient Care Management/standards , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Poland/epidemiology , SARS-CoV-2 , Secondary Prevention/methods , Uterine Cervical Neoplasms/diagnosis , Uterine Cervical Neoplasms/prevention & control
8.
Int J Gynecol Cancer ; 30(8): 1097-1100, 2020 08.
Article in English | MEDLINE | ID: covidwho-505825
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