NP Medical News about Cervical cancer screening; HPV-DNA test; cytology; rural China

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Human Papillomavirus Testing for Cervical Cancer Screening: Results From a 6-Year Prospective Study in Rural China
American Journal of Epidemiology, 08/20/09

Shi J–F et al. – This prospective study assessed the risk of future cervical intraepithelial neoplasia grade 2 or worse (CIN2+) associated with baseline human papillomavirus (HPV) and cytologic status...This study demonstrates that a single oncogenic HPV–DNA test is more effective than cytology in predicting future CIN2+ status.

Methods

In rural China, 1,997 women were screened with 6 screening tests, including colposcopic evaluations, and underwent biopsies in 1999.
In December 2005, 1,612 women with cervical intraepithelial neoplasia grade 1 or less at baseline were rescreened by visual inspection, liquid–based cytology, and HPV–DNA testing.
All women underwent colposcopy at follow–up, with biopsies taken from women with visually apparent lesions or cytologic abnormalities.

Results

Twenty women developed incident CIN2+.
The crude relative risk of CIN2+ for baseline HPV–positive women was 52 (95% confidence interval: 12.1, 222.5).
The crude relative risk of CIN2+ was 167 (95% confidence interval: 21.9, 1,265) for baseline and follow–up repeatedly HPV–positive women compared with repeatedly HPV–negative women.
Among 1,374 baseline HPV–negative women, 2 and no incident CIN2+ cases were detected in baseline cytologically normal and abnormal subgroups, respectively.
Among 238 baseline HPV–positive women, 6 of 18 incident cases of CIN2+ developed in the cytologically normal group.

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