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Quality control of cervical cytology using a 3-type HPV mRNA test increases screening program sensitivity of cervical intraepithelial neoplasia grade 2+ in young Norwegian women—A cohort study

PLoS Neglected Tropical Diseases Nov 11, 2019

Westre B, et al. - Researchers aimed at evaluating the increment in program sensitivity of CIN2+ after a follow-up of women with false-negative Pap-smears testing positive for a 3-type (-16, -18, -45) HPV mRNA test in a cohort design over one screening interval. The study cohorts included 521 women, aged 23–39 years, and no prior history of CIN1+ or HSIL, with atypical cells of undetermined significance (ASC-US) or worse smear (ASC-US+) and 1,444 women with normal screening cytology. They identified a positivity rate of 1.9% (28/1444) for the 3-type HPV mRNA. Rescreening revealed 23 women with ASC-US, two women with low-grade squamous intraepithelial lesion, two women with ASC-H, and one woman with AGUS. It is estimated that application of the HPV mRNA-positivity rate and histology findings from samples rescreened to all women with normal cytology may result in a calculated increase in screening sensitivity of 16.4% (95% CI:15.3–17.5) for CIN2+ and 17.3% (95% CI:16.2–18.4) for CIN3+. A significant increase in screening program sensitivity was achieved when rescreening was performed of less than 2% of women with normal cytology positive for a 3-type HPV mRNA test.
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