Comparison of measurements of human papillomavirus persistence for postcolposcopic surveillance for cervical precancerous lesions

Julia C. Gage, Mark Schiffman, Diane Solomon, Cosette M. Wheeler, Philip E. Castle

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Objective: Following guidelines, women evaluated by colposcopy, but not found to have a precancerous lesion, could be tested again at 12 months for carcinogenic human papillomavirus (HPV). Compared with pooled-probe testing, measuring HPV genotype-specific persistence might better predict subsequent grade 3 cervical intraepithelial neoplasia (CIN3). Methods: For women enrolled in the immediate colposcopy arm of the Atypical squamous cells of undetermined significance (ASCUS) and Low-grade squamous intraepithelial lesion (LSIL) Triage Study (ALTS), who underwent enrollment colposcopy but were without prevalently detected CIN2 or worse (CIN2+; n = 671), we compared 1-year HPV persistence, as measured by a pooled HPV genotype test (hybrid capture 2; hc2) versus a research PCR HPV genotyping test (line blot assay; LBA) as predictors of "missed prevalent" or possibly incident CIN3 diagnosed between 12 and 24 months. Results: Thirty-two (4.8%) women were diagnosed with subsequent CIN3. Testing repeatedly hc2-positive (hc2+) was more common (49.0%) than genotype-specific persistence as detected by LBA (30.3%, P < 0.01). Although absolute risks of CIN3 following repeat hc2+ or genotype-specific persistence were similar (8.8% versus 8.4%, P = 0.86), repeat hc2+ was more sensitive for identifying CIN3 than genotype-specific persistence (90.6% versus 53.1%, P < 0.01). Among 329 women repeatedly hc2+, women with persistent HPV16 were at higher risk of CIN3 than non-HPV16-persistent women (23.1% versus 7.0%, P < 0.01). Conclusions: For postcolposcopy management, 1-year HPV persistence as measured by hc2 would recall more women but was more sensitive and similarly predictive for CIN3 in the following year than detection of genotype-specific persistence by LBA. Impact: Although find little utility for measuring type-specific persistence, testing for persistent HPV16 might be clinically useful.

Original languageEnglish (US)
Pages (from-to)1668-1674
Number of pages7
JournalCancer Epidemiology Biomarkers and Prevention
Volume19
Issue number7
DOIs
StatePublished - 2010
Externally publishedYes

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Genotype
Colposcopy
Cervical Intraepithelial Neoplasia
Triage
Guidelines
Polymerase Chain Reaction
Research

ASJC Scopus subject areas

  • Epidemiology
  • Oncology
  • Medicine(all)

Cite this

Comparison of measurements of human papillomavirus persistence for postcolposcopic surveillance for cervical precancerous lesions. / Gage, Julia C.; Schiffman, Mark; Solomon, Diane; Wheeler, Cosette M.; Castle, Philip E.

In: Cancer Epidemiology Biomarkers and Prevention, Vol. 19, No. 7, 2010, p. 1668-1674.

Research output: Contribution to journalArticle

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title = "Comparison of measurements of human papillomavirus persistence for postcolposcopic surveillance for cervical precancerous lesions",
abstract = "Objective: Following guidelines, women evaluated by colposcopy, but not found to have a precancerous lesion, could be tested again at 12 months for carcinogenic human papillomavirus (HPV). Compared with pooled-probe testing, measuring HPV genotype-specific persistence might better predict subsequent grade 3 cervical intraepithelial neoplasia (CIN3). Methods: For women enrolled in the immediate colposcopy arm of the Atypical squamous cells of undetermined significance (ASCUS) and Low-grade squamous intraepithelial lesion (LSIL) Triage Study (ALTS), who underwent enrollment colposcopy but were without prevalently detected CIN2 or worse (CIN2+; n = 671), we compared 1-year HPV persistence, as measured by a pooled HPV genotype test (hybrid capture 2; hc2) versus a research PCR HPV genotyping test (line blot assay; LBA) as predictors of {"}missed prevalent{"} or possibly incident CIN3 diagnosed between 12 and 24 months. Results: Thirty-two (4.8{\%}) women were diagnosed with subsequent CIN3. Testing repeatedly hc2-positive (hc2+) was more common (49.0{\%}) than genotype-specific persistence as detected by LBA (30.3{\%}, P < 0.01). Although absolute risks of CIN3 following repeat hc2+ or genotype-specific persistence were similar (8.8{\%} versus 8.4{\%}, P = 0.86), repeat hc2+ was more sensitive for identifying CIN3 than genotype-specific persistence (90.6{\%} versus 53.1{\%}, P < 0.01). Among 329 women repeatedly hc2+, women with persistent HPV16 were at higher risk of CIN3 than non-HPV16-persistent women (23.1{\%} versus 7.0{\%}, P < 0.01). Conclusions: For postcolposcopy management, 1-year HPV persistence as measured by hc2 would recall more women but was more sensitive and similarly predictive for CIN3 in the following year than detection of genotype-specific persistence by LBA. Impact: Although find little utility for measuring type-specific persistence, testing for persistent HPV16 might be clinically useful.",
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N2 - Objective: Following guidelines, women evaluated by colposcopy, but not found to have a precancerous lesion, could be tested again at 12 months for carcinogenic human papillomavirus (HPV). Compared with pooled-probe testing, measuring HPV genotype-specific persistence might better predict subsequent grade 3 cervical intraepithelial neoplasia (CIN3). Methods: For women enrolled in the immediate colposcopy arm of the Atypical squamous cells of undetermined significance (ASCUS) and Low-grade squamous intraepithelial lesion (LSIL) Triage Study (ALTS), who underwent enrollment colposcopy but were without prevalently detected CIN2 or worse (CIN2+; n = 671), we compared 1-year HPV persistence, as measured by a pooled HPV genotype test (hybrid capture 2; hc2) versus a research PCR HPV genotyping test (line blot assay; LBA) as predictors of "missed prevalent" or possibly incident CIN3 diagnosed between 12 and 24 months. Results: Thirty-two (4.8%) women were diagnosed with subsequent CIN3. Testing repeatedly hc2-positive (hc2+) was more common (49.0%) than genotype-specific persistence as detected by LBA (30.3%, P < 0.01). Although absolute risks of CIN3 following repeat hc2+ or genotype-specific persistence were similar (8.8% versus 8.4%, P = 0.86), repeat hc2+ was more sensitive for identifying CIN3 than genotype-specific persistence (90.6% versus 53.1%, P < 0.01). Among 329 women repeatedly hc2+, women with persistent HPV16 were at higher risk of CIN3 than non-HPV16-persistent women (23.1% versus 7.0%, P < 0.01). Conclusions: For postcolposcopy management, 1-year HPV persistence as measured by hc2 would recall more women but was more sensitive and similarly predictive for CIN3 in the following year than detection of genotype-specific persistence by LBA. Impact: Although find little utility for measuring type-specific persistence, testing for persistent HPV16 might be clinically useful.

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