Is Primary HPV with Secondary p16/Ki67 Dual-Stain an Alternative HSIL-Risk Detection Strategy in Cervical Cancer Screening for Women under 30 Years?

Recently, cervical cancer rates elevation has been noted in women aged 20–39 years in regions with a very high human development index (HDI). The onset of cancer elevation rates is observed in the age range of 25–29 years, which should necessitate effective precancer screening in younger age groups,...

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Autores principales:	Martyna Trzeszcz, Maciej Mazurec, Robert Jach, Karolina Mazurec, Zofia Jach, Izabela Kotkowska-Szeps, Magdalena Kania, Mariola Wantuchowicz, Anna Prokopyk, Piotr Barcikowski, Marcin Przybylski, Joanna Wach, Agnieszka Halon
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	cervical cancer screening high-risk HPV HPV DNA p16/Ki67 dual-stain cancer biomarkers CINtec PLUS Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/02b876a2256c445d90c79f265471e952
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spelling	oai:doaj.org-article:02b876a2256c445d90c79f265471e9522021-11-25T17:20:43ZIs Primary HPV with Secondary p16/Ki67 Dual-Stain an Alternative HSIL-Risk Detection Strategy in Cervical Cancer Screening for Women under 30 Years?10.3390/diagnostics111120122075-4418https://doaj.org/article/02b876a2256c445d90c79f265471e9522021-10-01T00:00:00Zhttps://www.mdpi.com/2075-4418/11/11/2012https://doaj.org/toc/2075-4418Recently, cervical cancer rates elevation has been noted in women aged 20–39 years in regions with a very high human development index (HDI). The onset of cancer elevation rates is observed in the age range of 25–29 years, which should necessitate effective precancer screening in younger age groups, including those <25 years. From 30.066 liquid-based screening tests results (<i>n</i> = 30.066), 3849 liquid-based cytology, 1321 high-risk human papillomavirus (HRHPV) and 316 p16/Ki67 performed in women <30 years were selected. Performance characteristics were calculated for three screening models: primary HRHPV with p16/Ki67 triage, primary cytology with reflex HPV and primary cytology alone. Primary HRHPV with p16/Ki67 triage was significantly more sensitive in high-grade squamous intraepithelial lesion quantified with cervical intraepithelial neoplasia grade 2 or worse [HSIL(CIN2+)] detection than cytology with reflex HRHPV and cytology alone (83.3% vs. 70.8%/45.8%) and had significantly higher diagnostic predictive values (PPV:29.4%/21.3%/22.9%; NPV:91.7%/82.9%/82.2%, respectively at CIN2+ threshold). The number of colposcopies per HSIL(CIN2+) detection indices was 3.4, 4.7 and 4.4, respectively. Primary HPV testing in women <30 years with p16/Ki67 triage of HPV-positive cases might be an effective cervical cancer screening strategy for HSIL(CIN2+) detection with superior diagnostic performance when compared with primary cytology-based models. Women <25 years might also benefit from an introduction to a more sensitive screening approach.Martyna TrzeszczMaciej MazurecRobert JachKarolina MazurecZofia JachIzabela Kotkowska-SzepsMagdalena KaniaMariola WantuchowiczAnna ProkopykPiotr BarcikowskiMarcin PrzybylskiJoanna WachAgnieszka HalonMDPI AGarticlecervical cancer screeninghigh-risk HPVHPV DNAp16/Ki67 dual-staincancer biomarkersCINtec PLUSMedicine (General)R5-920ENDiagnostics, Vol 11, Iss 2012, p 2012 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	cervical cancer screening high-risk HPV HPV DNA p16/Ki67 dual-stain cancer biomarkers CINtec PLUS Medicine (General) R5-920
spellingShingle	cervical cancer screening high-risk HPV HPV DNA p16/Ki67 dual-stain cancer biomarkers CINtec PLUS Medicine (General) R5-920 Martyna Trzeszcz Maciej Mazurec Robert Jach Karolina Mazurec Zofia Jach Izabela Kotkowska-Szeps Magdalena Kania Mariola Wantuchowicz Anna Prokopyk Piotr Barcikowski Marcin Przybylski Joanna Wach Agnieszka Halon Is Primary HPV with Secondary p16/Ki67 Dual-Stain an Alternative HSIL-Risk Detection Strategy in Cervical Cancer Screening for Women under 30 Years?
description	Recently, cervical cancer rates elevation has been noted in women aged 20–39 years in regions with a very high human development index (HDI). The onset of cancer elevation rates is observed in the age range of 25–29 years, which should necessitate effective precancer screening in younger age groups, including those <25 years. From 30.066 liquid-based screening tests results (<i>n</i> = 30.066), 3849 liquid-based cytology, 1321 high-risk human papillomavirus (HRHPV) and 316 p16/Ki67 performed in women <30 years were selected. Performance characteristics were calculated for three screening models: primary HRHPV with p16/Ki67 triage, primary cytology with reflex HPV and primary cytology alone. Primary HRHPV with p16/Ki67 triage was significantly more sensitive in high-grade squamous intraepithelial lesion quantified with cervical intraepithelial neoplasia grade 2 or worse [HSIL(CIN2+)] detection than cytology with reflex HRHPV and cytology alone (83.3% vs. 70.8%/45.8%) and had significantly higher diagnostic predictive values (PPV:29.4%/21.3%/22.9%; NPV:91.7%/82.9%/82.2%, respectively at CIN2+ threshold). The number of colposcopies per HSIL(CIN2+) detection indices was 3.4, 4.7 and 4.4, respectively. Primary HPV testing in women <30 years with p16/Ki67 triage of HPV-positive cases might be an effective cervical cancer screening strategy for HSIL(CIN2+) detection with superior diagnostic performance when compared with primary cytology-based models. Women <25 years might also benefit from an introduction to a more sensitive screening approach.
format	article
author	Martyna Trzeszcz Maciej Mazurec Robert Jach Karolina Mazurec Zofia Jach Izabela Kotkowska-Szeps Magdalena Kania Mariola Wantuchowicz Anna Prokopyk Piotr Barcikowski Marcin Przybylski Joanna Wach Agnieszka Halon
author_facet	Martyna Trzeszcz Maciej Mazurec Robert Jach Karolina Mazurec Zofia Jach Izabela Kotkowska-Szeps Magdalena Kania Mariola Wantuchowicz Anna Prokopyk Piotr Barcikowski Marcin Przybylski Joanna Wach Agnieszka Halon
author_sort	Martyna Trzeszcz
title	Is Primary HPV with Secondary p16/Ki67 Dual-Stain an Alternative HSIL-Risk Detection Strategy in Cervical Cancer Screening for Women under 30 Years?
title_short	Is Primary HPV with Secondary p16/Ki67 Dual-Stain an Alternative HSIL-Risk Detection Strategy in Cervical Cancer Screening for Women under 30 Years?
title_full	Is Primary HPV with Secondary p16/Ki67 Dual-Stain an Alternative HSIL-Risk Detection Strategy in Cervical Cancer Screening for Women under 30 Years?
title_fullStr	Is Primary HPV with Secondary p16/Ki67 Dual-Stain an Alternative HSIL-Risk Detection Strategy in Cervical Cancer Screening for Women under 30 Years?
title_full_unstemmed	Is Primary HPV with Secondary p16/Ki67 Dual-Stain an Alternative HSIL-Risk Detection Strategy in Cervical Cancer Screening for Women under 30 Years?
title_sort	is primary hpv with secondary p16/ki67 dual-stain an alternative hsil-risk detection strategy in cervical cancer screening for women under 30 years?
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/02b876a2256c445d90c79f265471e952
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Is Primary HPV with Secondary p16/Ki67 Dual-Stain an Alternative HSIL-Risk Detection Strategy in Cervical Cancer Screening for Women under 30 Years?

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