American Journal of Obstetrics and Gynecology
ResearchOncologyPrior knowledge of HPV status improves detection of CIN2+ by cytology screening
Section snippets
Study population
In this prospective, colposcopy-controlled study, we enrolled 3126 voluntary participants from August 2005 until February 2007 (Figure 1). Samples were collected during opportunistic routine health checks by 11 selected gynecologists in Flanders (Belgium). All women gave written informed consent.
Exclusion criteria included pregnancy and history of cervical disease (previous history of CIN2+); 221 women were excluded. At enrollment, participants underwent a colposcopy after smear taking.
Characteristics of the population
In total, 3126 women were eligible for inclusion of the current study. After exclusion of 221 subjects with antecedents of cervical neoplasia and/or pregnancy, 2905 participants were included in the final study group. The median age was 42.7 years (first quartile, 32.9; third quartile, 51.9). Eighty-four percent of the study population belonged to the target age group of 25-64 years, for whom screening is recommended in Belgium.16 The proportion of younger (<30 years) women in the study
Comment
This study demonstrates that prior knowledge of presence of HR-HPV types increased cytological detection of CIN 2 grade lesions or worse. Compared with cytology alone, knowledge of the HPV status resulted in a gain in sensitivity of 30%, a slight loss in specificity, however, without loss of positive predictive value.
The prevalence of HR-HPV genotypes in our study population was similar to the national distribution, indicating that a representative sample was taken.11 It remains to be
Acknowledgments
We wish to thank the cytotechnologists, Kristin Van Belle, Sabrina Van Belle, Linda De Kreyger, and Sandy Van Den Eynde, and laboratory technicians, Rachel Baveco, Ludo Boels, Anneleen Cremers, Carmen de Maerschalck, Nadine Deckers, Kathlijne De Preter, Sabine Dierickx, Brenda Gabriels, Inge Goegebeur, Karen Ileghems, Kim Van Beek, Miranda Vervoort, and Marleen Wauters, for excellent technical support. Chantal Vanden Bosch offered secretarial support. We are sincerely grateful to Carolyne
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The first 2 authors contributed equally to the study and manuscript.
M.A. is supported by the Belgian Foundation Against Cancer, Brussels, Belgium, and the European Commission (DG Sanco, Luxembourg) through the ECCG Project (European Cooperation on Development and Implementation of Cancer Screening and Prevention Guidelines, IARC, Lyon, France). D.V.B. is supported by the Flemish Fund for Scientific Research.
The authors report no conflict of interest.
Cite this article as: Benoy IH, Vanden Broeck D, Ruymbeke MJ, et al. Prior knowledge of HPV status improves detection of CIN2+ by cytology screening. Am J Obstet Gynecol 2011;205:569.e1-7.