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Risk assessment of self-sampling HPV tests based on PCR, signal amplification to guide the appropriate screening intervals: A prospective study in China

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机构: [1]Chinese Acad Med Sci & Peking Union Med Coll, Canc Hosp, Natl Cancer Ctr, Dept Epidemiol,Clin Res Ctr Canc, Beijing, Peoples R China [2]Chinese Acad Med Sci, Beijing Hosp, Inst Geriatr Med, Clin Trial Res Ctr,Natl ctr Gerontol, Beijing, Peoples R China [3]Xinjiang Med Univ, Affiliated Tumor Hosp, Dept Canc Res Inst, Urumqi, Peoples R China [4]Beijing Tongren Hosp, Dept Obstet & Gynecol, Beijing, Peoples R China [5]Chinese Acad Med Sci & Peking Union Med Coll, Canc Hosp, Natl Canc Ctr, Natl Clin Res Ctr,Dept Pathol, Beijing, Peoples R China [6]Chinese Acad Med Sci & Peking Union Med Coll, Sch Populat Med & Publ Hlth, Beijing, Peoples R China [7]Belgian Canc Ctr, Sciensano, Unit Canc Epidemiol, Brussels, Belgium
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关键词: Human papillomavirus test Self-sampling Risk management Screening interval

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Objective: We assessed the longitudinal risk of developing cervical intraepithelial neoplasia (CINs) with self sampling human papillomavirus (HPV) tests, based on polymerase chain reaction (PCR) and signal amplification (careHPV), to explore the appropriate intervals for cervical cancer screening.Methods: A prospective study was conducted in China during 20172020. Participants were invited for PCR and careHPV tests with self-samples at baseline. Women positive in either HPV test underwent colposcopy and biopsy if necessary. Women with baseline CIN grade one (CIN1) or less were followed up over 3 years. The absolute risk was assessed by the immediate risk (IR) and cumulative risk (CR), and the relative risk was assessed by the hazard ratio (HR) with a 95% confidence interval (CI).Results: A total of 8,126 women were included in the final analysis. Women positive for the PCR HPV test had comparable IRs of CIN2+ and CIN3+ to those positive on the careHPV test. With triage by HPV genotyping, women with HPV 16/18 infection had the highest IRs of CIN2+ (21.15%) and CIN3+ (9.67%). For CR, women negative for PCR HPV test had a lower risk of CIN2+ than that reported in women negative on careHPV test (0.57% versus 0.98%, HR = 0.58, 95% CI: 0.38, 0.87), but no significant difference was found in the CRs of CIN3+ between them (0.25% versus 0.39%, HR = 0.64, 95% CI: 0.34, 1.20). Among women with CIN1 or less at baseline, women who were persistent or recurrent positive on careHPV or PCR HPV test had a higher risk of developing CIN3+ (11.36%-14.59%), compared with women remained HPV negative from baseline throughout follow-up (<= 0.28%).Conclusions: Routine screening with 3-year intervals is acceptable for self-sampling HPV tests based on PCR or careHPV test. Women positive on HPV16/18 triaging at baseline or with CIN1 or less at baseline while being persistent or recurrent positive on careHPV or PCR HPV test during 3-year follow-up require immediate colposcopy or treatment.

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大类 | 3 区 医学
小类 | 3 区 肿瘤学
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Q1 ONCOLOGY

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第一作者机构: [1]Chinese Acad Med Sci & Peking Union Med Coll, Canc Hosp, Natl Cancer Ctr, Dept Epidemiol,Clin Res Ctr Canc, Beijing, Peoples R China
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