Human papillomavirus viral load as a useful triage tool for non-16/18 high-risk human papillomavirus positive women: A prospective screening cohort study Public Deposited

Analytics

Downloadable Content

Download PDF
Request Accessible Version
Creator
  • Dong, Li
    • Other Affiliation: Institutes of Biomedical Sciences; Shanxi University
  • Wang, Margaret Z.
    • Other Affiliation: UJMT Fogarty Consortium; NIH Fogarty International Center
  • Zhao, Xue-lian
    • Other Affiliation: Department of Epidemiology; National Cancer Center/Cancer Hospital; Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC)
  • Feng, Rui-mei
    • Other Affiliation: Department of Epidemiology; National Cancer Center/Cancer Hospital; Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC)
  • Hu, Shang-ying
    • Other Affiliation: Department of Epidemiology; National Cancer Center/Cancer Hospital; Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC)
  • Zhang, Qian
    • Other Affiliation: Department of Epidemiology; National Cancer Center/Cancer Hospital; Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC)
  • Smith, Jennifer S.
    • Affiliation: Gillings School of Global Public Health, Department of Epidemiology
    • Other Affiliation: University of North Carolina at Chapel Hill
  • Qiao, You-lin
    • Other Affiliation: Department of Epidemiology; National Cancer Center/Cancer Hospital; Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC)
  • Zhao, Fang-hui
    • ORCID: 0000-0001-9294-0005
    • Other Affiliation: Department of Epidemiology; National Cancer Center/Cancer Hospital; Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC)
Abstract
  • ASCCP cervical cancer screening guidelines recommend triaging high-risk human papillomavirus (hrHPV) positive women with cytology and genotyping, but cytology is often unavailable in resource-limited areas. We compared the long-term risk of cervical cancer and precancers among type-specific hrHPV-positive women triaged by viral load to cytology and visual inspection with acetic acid (VIA).A cohort of 1742 Chinese women was screened with cytology, VIA, and Hybrid Capture 2 (HC2) test and followed for ten years. All HC2-positive samples were genotyped. Viral load was measured by HC2 relative light units/cutoff (RLU/CO). Ten-year cumulative incidence rate (CIR) of cervical intraepithelial neoplasia grade 2 or worse (CIN2 +) for type-specific hrHPV viral load was estimated using Kaplan-Meier methods.Baseline hrHPV viral load stratified by specific genotypes was positively correlated with prevalent cytological lesions. Ten-year CIR of CIN2 + was associated with cytological lesions and viral load. Among HPV 16/18-positive women, ten-year CIR of CIN2 + was high, even with normal cytology (15.3%), normal VIA (32.4%), viral load with RLU/CO < 10 (23.6%) or RLU/CO < 100 (33.8%). Among non-16/18 hrHPV positive women, ten-year CIR of CIN2 + was significantly stratified by cytology grade of atypical squamous cell of undetermined significance or higher (2.0% VS. 34.6%), viral load cutoffs at 10 RLU/CO (5.1% VS. 27.2%), at 100 RLU/CO (11.0% VS. 35.5%), but not by VIA (19.1% VS. 19.0%).Our findings support the guidelines in referring all HPV16/18 positive women to colposcopy and suggest triaging non-16/18 hrHPV positive women using viral loads in resource-limited areas where cytology screening was inaccessible.
Date of publication
Keyword
DOI
Identifier
Resource type
  • Article
Rights statement
  • In Copyright
Journal title
  • Gynecologic Oncology
Journal volume
  • 148
Journal issue
  • 1
Page start
  • 103
Page end
  • 110
Language
  • English
ISSN
  • 1051-2012
  • 0090-8258
  • 1095-6859
Parents:

This work has no parents.

Items

Thumbnail Title Date Uploaded Visibility Actions
64f6576c71fd99e01f710c2d09acec17f315f771.pdf 2018 Public