Effectiveness of high-risk human papillomavirus genotyping for cervical cancer screening. A multicentre screening cohort study in rural China

Egileak

  • Yan-Qin Yu National Cancer Center /National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College
  • Ming-Yue Jiang National Cancer Centre /National Clinical Research Centre for Cancer/Cancer Hospital. Chinese Academy of Medical Sciences and Peking Union Medical College. Department of Cancer Epidemiology. Beijing. China
  • Xun Zhang National Cancer Centre /National Clinical Research Centre for Cancer/Cancer Hospital. Chinese Academy of Medical Sciences and Peking Union Medical College. Department of Cancer Epidemiology. Beijing. China
  • Qin-Jing Pan National Cancer Centre /National Clinical Research Centre for Cancer/Cancer Hospital. Chinese Academy of Medical Sciences and Peking Union Medical College. Department of Cancer Epidemiology. Beijing. China
  • Le Dang National Cancer Centre /National Clinical Research Centre for Cancer/Cancer Hospital. Chinese Academy of Medical Sciences and Peking Union Medical College. Department of Cancer Epidemiology. Beijing. China
  • Rui-Mei Feng 2 National Cancer Centre /National Clinical Research Centre for Cancer/Cancer Hospital. Chinese Academy of Medical Sciences and Peking Union Medical College. Department of Cancer Epidemiology. Beijing. China
  • Naasra Mohamoud Ali First Affiliated Hospital of Dalian Medical University. Department of Oncology. Dalian. China
  • Wen Chen Baotou Medical College/Clinical Epidemiology Research Centre of The First Affiliated Hospital of Baotou Medical College. Department of Public Health and Preventive Medicine. Baotou. China
  • You-Lin Qiao National Cancer Centre /National Clinical Research Centre for Cancer/Cancer Hospital. Chinese Academy of Medical Sciences and Peking Union Medical College. Department of Cancer Epidemiology. Beijing. China

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https://doi.org/10.23938/ASSN.1065

Gako-hitzak:

Papillomavirus Infections, Uterine Cervical Neoplasms, Mass Screening, Rural Areas, China

Laburpena

Background. This study aimed to assess the effectiveness of high-risk human papillomavirus (HR-HPV) primary testing for cervical cancer screening in China’s rural areas.

Methods. Women aged 21-64 years were recruited. Cervical cytology was diagnosed following the Bethesda 2001 classification system, HPV infection (HR-HPV, HPV-16, HPV-18, and other 12 genotypes) identified by Cobas-4800, and colposcopy and biopsy performed when required. Primary outcomes were defined as the cumulative incidence of cervical intraepithelial neoplasia grade 2/3/higher (CIN2/3+) and its relative risk at baseline and at the 36-month follow-up.

Results. The study included 9,218 women; mean age was 45.15 years (SD: 8.74); 81% completed the follow-up. The most frequent type of cytological lesions (12.4% ) were ASCUS (8.4%) and LSIL (2.2%). HR-HPV infection (16.3%) was more prevalent in HPV-16 than in HPV-18 (3 vs 1.5%); a positive relationship with the severity of the lesions, from 29.8% in ASCUS to 89.6% in HSIL was found. At baseline, 3.5% of the patients underwent colposcopy; 20% had a positive diagnosis. At the 36-month follow-up, the cumulative incidences of CIN2+ and CIN3+ were higher in women with HR-HPV infection (16.9 vs 0.5% and 8.2 vs 0.2%). The relative risk of CIN2/3+ was lower in HR-HPV-negative women compared to those with a negative cytology at baseline (0.4; 95%CI: 0.3–0.4).

Conclusions. High-risk HPV-based screening may significantly reduce the risk of CIN2/3+ compared with cytology testing. This may be a new resource for public health demands in China’s rural areas.

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1 Baotou Medical College/Clinical Epidemiology Research Centre of The First Affiliated Hospital of Baotou Medical College. Department of Public Health and Preventive Medicine. Baotou. China

2 National Cancer Centre /National Clinical Research Centre for Cancer/Cancer Hospital. Chinese Academy of Medical Sciences and Peking Union Medical College. Department of Cancer Epidemiology. Beijing. China

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2 National Cancer Centre /National Clinical Research Centre for Cancer/Cancer Hospital. Chinese Academy of Medical Sciences and Peking Union Medical College. Department of Cancer Epidemiology. Beijing. China

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2 National Cancer Centre /National Clinical Research Centre for Cancer/Cancer Hospital. Chinese Academy of Medical Sciences and Peking Union Medical College. Department of Cancer Epidemiology. Beijing. China

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2 National Cancer Centre /National Clinical Research Centre for Cancer/Cancer Hospital. Chinese Academy of Medical Sciences and Peking Union Medical College. Department of Cancer Epidemiology. Beijing. China

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2 National Cancer Centre /National Clinical Research Centre for Cancer/Cancer Hospital. Chinese Academy of Medical Sciences and Peking Union Medical College. Department of Cancer Epidemiology. Beijing. China

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2 National Cancer Centre /National Clinical Research Centre for Cancer/Cancer Hospital. Chinese Academy of Medical Sciences and Peking Union Medical College. Department of Cancer Epidemiology. Beijing. China

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3 First Affiliated Hospital of Dalian Medical University. Department of Oncology. Dalian. China

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1 Baotou Medical College/Clinical Epidemiology Research Centre of The First Affiliated Hospital of Baotou Medical College. Department of Public Health and Preventive Medicine. Baotou. China

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2 National Cancer Centre /National Clinical Research Centre for Cancer/Cancer Hospital. Chinese Academy of Medical Sciences and Peking Union Medical College. Department of Cancer Epidemiology. Beijing. China

4 School of Population Medicine and Public Health. Chinese Academy of Medical Sciences and Peking Union Medical College. Beijing. China

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2024-05-31

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Yu, Y.-Q., Jiang, M.-Y. ., Zhang, X., Pan, Q.-J., Dang, L., Feng, R.-M., Ali, N. M., Chen, W., & Qiao, Y.-L. (2024). Effectiveness of high-risk human papillomavirus genotyping for cervical cancer screening. A multicentre screening cohort study in rural China. Anales Del Sistema Sanitario De Navarra, 47(2), e1065. https://doi.org/10.23938/ASSN.1065

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bol: 47 zk: 2 (2024): mayo - agosto 2024

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