Molecular triage of cervical screening samples in women 55–59 years of age: a pilot study
Abstract Background With HPV screening the specificity of screening positives has decreased, even with a cytological triage test. Increases in colposcopies and detection of benign or low-grade dysplasia are reported, not least in older women. These results highlight the necessity to find other triag...
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| Format: | Article |
| Language: | English |
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BMC
2023-05-01
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| Series: | Infectious Agents and Cancer |
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| Online Access: | https://doi.org/10.1186/s13027-023-00510-1 |
| _version_ | 1827940027805466624 |
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| author | Gisela Helenius Gabriella Lillsunde-Larsson Lovisa Bergengren |
| author_facet | Gisela Helenius Gabriella Lillsunde-Larsson Lovisa Bergengren |
| author_sort | Gisela Helenius |
| collection | DOAJ |
| description | Abstract Background With HPV screening the specificity of screening positives has decreased, even with a cytological triage test. Increases in colposcopies and detection of benign or low-grade dysplasia are reported, not least in older women. These results highlight the necessity to find other triage tests in HPV screening strategies, so that women can be more accurately selected for colposcopy, thus minimizing the clinically irrelevant findings. Methods The study included 55- to 59-year-old women who exited the screening with normal cytology, but later in a follow-up test were positive for the HPV genotypes 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66 and 68 and had a cervical cone biopsy done. To model a screening situation with hrHPV-positive women, three different triage strategies, namely, cytology, genotyping and methylation, were performed. The study considered the effect of direct referral to colposcopy for HPV genotypes 16, 18, 31, 33, 45, 52 and 58, and methylation for FAM19A4 and hsa-mir124-2 and/or any form of abnormal cytology. Results Seven out of 49 women aged 55–59 years with hrHPV had a cone biopsy with high-grade squamous intraepithelial lesion. No triage method found all cases, and when comparing positive and negative predictive value and false negative rate, cytology showed better results than genotyping and methylation. Conclusion This study does not support a switch in triage strategies from cytology to hrHPV genotyping and methylation for women above 55 years of age yet, but demonstrates the need for more evidence on molecular triage strategies. |
| first_indexed | 2024-03-13T09:04:33Z |
| format | Article |
| id | doaj.art-353be51da7174e2481a3ed11a505332a |
| institution | Directory Open Access Journal |
| issn | 1750-9378 |
| language | English |
| last_indexed | 2024-03-13T09:04:33Z |
| publishDate | 2023-05-01 |
| publisher | BMC |
| record_format | Article |
| series | Infectious Agents and Cancer |
| spelling | doaj.art-353be51da7174e2481a3ed11a505332a2023-05-28T11:08:58ZengBMCInfectious Agents and Cancer1750-93782023-05-011811610.1186/s13027-023-00510-1Molecular triage of cervical screening samples in women 55–59 years of age: a pilot studyGisela Helenius0Gabriella Lillsunde-Larsson1Lovisa Bergengren2School of Health Sciences, Örebro UniversitySchool of Health Sciences, Örebro UniversityDepartment of Women’s Health, Faculty of Medicine and Health, Örebro UniversityAbstract Background With HPV screening the specificity of screening positives has decreased, even with a cytological triage test. Increases in colposcopies and detection of benign or low-grade dysplasia are reported, not least in older women. These results highlight the necessity to find other triage tests in HPV screening strategies, so that women can be more accurately selected for colposcopy, thus minimizing the clinically irrelevant findings. Methods The study included 55- to 59-year-old women who exited the screening with normal cytology, but later in a follow-up test were positive for the HPV genotypes 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66 and 68 and had a cervical cone biopsy done. To model a screening situation with hrHPV-positive women, three different triage strategies, namely, cytology, genotyping and methylation, were performed. The study considered the effect of direct referral to colposcopy for HPV genotypes 16, 18, 31, 33, 45, 52 and 58, and methylation for FAM19A4 and hsa-mir124-2 and/or any form of abnormal cytology. Results Seven out of 49 women aged 55–59 years with hrHPV had a cone biopsy with high-grade squamous intraepithelial lesion. No triage method found all cases, and when comparing positive and negative predictive value and false negative rate, cytology showed better results than genotyping and methylation. Conclusion This study does not support a switch in triage strategies from cytology to hrHPV genotyping and methylation for women above 55 years of age yet, but demonstrates the need for more evidence on molecular triage strategies.https://doi.org/10.1186/s13027-023-00510-1Cervical screeningCytologyDNA methylationGenotypingHuman papillomavirus |
| spellingShingle | Gisela Helenius Gabriella Lillsunde-Larsson Lovisa Bergengren Molecular triage of cervical screening samples in women 55–59 years of age: a pilot study Infectious Agents and Cancer Cervical screening Cytology DNA methylation Genotyping Human papillomavirus |
| title | Molecular triage of cervical screening samples in women 55–59 years of age: a pilot study |
| title_full | Molecular triage of cervical screening samples in women 55–59 years of age: a pilot study |
| title_fullStr | Molecular triage of cervical screening samples in women 55–59 years of age: a pilot study |
| title_full_unstemmed | Molecular triage of cervical screening samples in women 55–59 years of age: a pilot study |
| title_short | Molecular triage of cervical screening samples in women 55–59 years of age: a pilot study |
| title_sort | molecular triage of cervical screening samples in women 55 59 years of age a pilot study |
| topic | Cervical screening Cytology DNA methylation Genotyping Human papillomavirus |
| url | https://doi.org/10.1186/s13027-023-00510-1 |
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