DOCSLIB.ORG

Effectiveness and Immunogenicity of One Dose of HPV Vaccine Compared with No HPV Vaccination

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Effectiveness and Immunogenicity of One Dose of HPV Vaccine Compared with No HPV Vaccination Effectiveness and immunogenicity of one dose of HPV vaccine compared with no vaccination, two doses, or three doses August 2019 – Final report Report contributors: Nicholas Henschke, Hanna Bergman, Brian Buckley, Elise Cogo, Katrin Probyn, Yanina Sguassero, Gemma Villanueva (Cochrane Response) Chantelle Garritty, Adrienne Stevens, Candyce Hamel (Ottawa Hospital Research Institute), Disclaimer: The authors of this report declare no conflicts of interest Trusted evidence. Informed decisions. Better health. One dose of HPV vaccine versus no vaccine, two (or three) doses 2 Table of contents Table of contents ............................................................................................................................................... 2 List of figures .................................................................................................................................................... 3 List of tables ...................................................................................................................................................... 4 Abbreviations ..................................................................................................................................................... 5 Executive summary ............................................................................................................................................ 6 Introduction ....................................................................................................................................................... 9 Methods .............................................................................................................................................................. 9 Search methods ...................................................................................................................................................... 9 Selection criteria ..................................................................................................................................................... 9 Study selection and data collection ..................................................................................................................... 10 Risk of bias assessment ........................................................................................................................................ 10 Data analysis ......................................................................................................................................................... 11 Summarising and interpreting results ................................................................................................................. 12 Results .............................................................................................................................................................. 13 Results of the search ............................................................................................................................................. 13 Characteristics of included studies ...................................................................................................................... 13 Risk of bias in included studies ............................................................................................................................ 19 Comparison 1. Effectiveness and immunogenicity of one dose of HPV vaccine compared with no HPV vaccination ............................................................................................................................................................ 23 Comparison 2. Effectiveness and immunogenicity of one dose of HPV vaccine compared with two doses ..... 34 Comparison 3. Effectiveness and immunogenicity of one dose of HPV vaccine compared with three doses .. 45 Conclusions ...................................................................................................................................................... 56 References ........................................................................................................................................................ 60 Appendix 1. Search strategies ......................................................................................................................... 63 Appendix 2. Included studies .......................................................................................................................... 65 Appendix 3. Causal DAG model for HPV vaccination in adolescents and young adult study populations... 68 Appendix 4. Characteristics of included studies ............................................................................................. 69 Appendix 5. ROBINS-I Summary ...................................................................................................................... 76 Appendix 6. SIGN-50 Summary........................................................................................................................ 78 Appendix 7. GRADE tables ............................................................................................................................... 79 One dose of HPV vaccine versus no vaccine, two (or three) doses 3 List of figures Figure 1. Ratio of HPV 16 and 18 GMTs for one dose bivalent HPV vaccine versus control (HAV vaccine) at 48 months follow-up, unadjusted results ................................................................................................................ 23 Figure 2. Histological abnormalities for one dose bivalent HPV vaccine versus no vaccine, adjusted results. 24 Figure 3. Prevalence of HPV infection for one dose bivalent HPV vaccine versus no vaccine, adjusted results25 Figure 4. One-time incident HPV infection for one dose bivalent HPV vaccine versus control (HAV), unadjusted results ................................................................................................................................................................... 25 Figure 5. Persistent HPV infection for one dose bivalent HPV vaccine versus control (HAV), unadjusted results .............................................................................................................................................................................. 26 Figure 6. Ratios of HPV GMTs for one dose quadrivalent HPV vaccine versus no vaccine at 72 months follow- up, unadjusted results ......................................................................................................................................... 27 Figure 7. HPV 6, 11, 16, and 18 seropositivity at 72 months follow-up for one dose quadrivalent HPV vaccine versus no vaccine ................................................................................................................................................. 27 Figure 8. Histological abnormalities for one dose quadrivalent HPV vaccine versus no vaccine, unadjusted results ................................................................................................................................................................... 30 Figure 9. Cytological abnormalities for one dose quadrivalent HPV vaccine versus no vaccine, unadjusted results ................................................................................................................................................................... 31 Figure 10. Genital warts for one dose quadrivalent HPV vaccine versus no vaccine, unadjusted results ........ 33 Figure 11. HPV infections for one dose quadrivalent HPV vaccine versus no vaccine over a 7-year follow-up period, unadjusted results ................................................................................................................................... 34 Figure 12. HPV 16 and 18 antibody titres for one dose versus two doses bivalent HPV vaccine at 24 to 84 months follow-up, unadjusted results .............................................................................................................................. 35 Figure 13. HPV 16 and 18 seropositivity for one dose versus two doses bivalent HPV vaccine at 24- and 48- months follow-up, unadjusted results ................................................................................................................ 36 Figure 14. CIN1, CIN2, CIN3 for one versus two doses bivalent HPV vaccine, unadjusted results .................... 36 Figure 15. Prevalence of HPV infection for one versus two doses bivalent HPV vaccine, unadjusted results .. 37 Figure 16. 7-year cumulative HPV infection for one versus two doses bivalent HPV vaccine, unadjusted results .............................................................................................................................................................................. 38 Figure 17. One-time incidence of HPV infection for one versus two doses bivalent HPV vaccine, unadjusted results ................................................................................................................................................................... 38 Figure 18. Persistent HPV infection for one versus two doses bivalent HPV vaccine, unadjusted results ........ 39 Figure 19. Ratio of GMTs for one dose versus two doses quadrivalent HPV vaccine at 12 to 72 months follow- up. ......................................................................................................................................................................... 40 Figure 20. HPV 6, 11, 16, and
Load more

Recommended publications
  • In Women with the Two Groups,3 When Judged by Colposcopy in a Relative
    Matters arising 145 4 Reynolds JEF (Ed) Martindale. The Extra Phar- There are a number of small points in With regard to the points raised by Drs macoepia, 29th ed. London: Pharmaceutical respect ofthe data they present which require Evans and Kell. Patients attending our clinic Press. 1989. 5 National Institute of Occupational Safety and clarification: the indications for taking a are offered cervical cytology if (a) they have Hazards. Recommendations for occupational cervical smear are actually not given and it is not had a smear within the last 3 years or (b) safety and health standards. 1988. Morbidity not clear whether the 185 patients represent they or their sexual partners have genital and mortality weekly report (suppl) warts and they have not had a smear within Genitourin Med: first published as 10.1136/sti.68.2.145-b on 1 April 1992. Downloaded from 1988;37:8. the total number smeared over the 5 month 6 Ethyl chloride BP. Production Information. period of study. It is really quite important to one year. The 185 women in the study were Berkshire UK. Bengue and Company Ltd know who was invited to participate and who drawn from 191 women having smears dur- 1982. declined. ing the study period. No patients declined to 7 Nordin C, Rosenguist M, Hollstedt C. Sniffing of ethyl chloride-an uncommon form of The proportion of abnormal smears was answer the life-style questions, but six abuse with serious mental and neurological much lower in the non-wart group (7 of 55) patients, all from the warts/warts contact symptoms.
    [Show full text]
  • Top Tips in 2 Minutes: Human Papilloma Virus (HPV) Vaccines
    Mike Fitzpatrick Carry on screening The vog ue for screening tests, driven by discuss any findings with your GP’. powerful commercial and political forces, The popular appeal of screening tests in an Top Tips in is having an increasingly malign influence anxious age results from the inflation to on our patients’ health (as well as mythical status of the commonsensical imposing a growing burden on our notion that early detection leads to a more 2 minutes surgeries). favourable outcome. But this is only true if In recent weeks, two patients have early treatment is effective: this has not The Department of Health has chosen the presented me with the results of some of been demonstrated, for example, in bivalent vaccine Cervarix ™ for its national the latest screening initiatives in the private relation to prostate cancer or in the case of vaccination programme in England. Although sector. One had paid around £3000 for the atheromatous carotid arteries. There is a this will protect against human papilloma virus ‘ultimate check-up’. 1 In addition to related presumption that late presentation (HPV) 16 and 18, which cause 70% of cervical consultation and examination, the check- is a common factor resulting in a rapid cancers, it will offer no protection against up included ‘over 40’ blood and urine demise, particularly from cancer, but again, tests, audiometry, ECG and spirometry, this has to be substantiated, especially genital warts. In 2006, there were 83 745 new and ultrasound examinations of all internal when it may be the case that delays and diagnoses of genital warts (first episode) and organs.
    [Show full text]
  • (HPV) Induced Cervical Dysplasia
    Cent. Eur. J. Biol.• 5(5) • 2010 • 554-571 DOI: 10.2478/s11535-010-0051-z Central European Journal of Biology Diagnostic role of p16/INK4A protein in Human Papillomavirus (HPV) induced cervical dysplasia Review Article Július Rajčáni1,2,*, Marián Adamkov1,3, Jana Hybenova1, Jaroslav Jackuliak1, Marian Benčat1 1Alpha Medical a.s., 03601 Martin, Slovak Republic 2Institute of Virology, Slovak Academy of Sciences, 84505 Bratislava, Slovak Republic 3Institute of Histology and Embryology, Jessenius Faculty of Medicine, Comenius University, 03601 Martin, Slovak Republic Received 15 October 2009; Accepted 13 April 2010 Abstract: The p16/INK4A protein is a cellular regulatory polypeptide over-expressed in the presence of high levels of the Human Papillomavirus (HPV) coded E7 protein. This review outlines the use of p16 antigen staining in cervical biopsies as well as in PAP smears summarizing the corresponding literature and commenting the authors’ own experience. The p16 antigen is a reliable marker for dysplastic cells in CINII/CINIII (HSIL) lesions as viewed in cervical biopsies. When PAP smears were examined at large scale screening for p16 antigen- reactive and atypical cells, considerable variations could be found especially in ASCUS graded lesions. Therefore, the presence of p16-reactive atypical cells in PAP smears should be interpreted together with the cytological signs of dysplasia, such as the altered N/C ratio. In addition, women revealing p16-positive ASCUS/LSIL specimens should be examined for the presence of HPV DNA. Detection of HPV DNA alone, i.e. in the absence of cytological screening has a low predictive value, since the clearance of HPV may occur even in the absence of morphological alterations.
    [Show full text]
  • Addition of High-Risk HPV Testing Improves the Current Guidelines on Follow-Up After Treatment for Cervical Intraepithelial Neoplasia
    British Journal of Cancer (2001) 84(6), 796–801 © 2001 Cancer Research Campaign doi: 10.1054/ bjoc.2000.1689, available online at http://www.idealibrary.com on http://www.bjcancer.com Addition of high-risk HPV testing improves the current guidelines on follow-up after treatment for cervical intraepithelial neoplasia MAE Nobbenhuis1,2, CJLM Meijer2, AJC van den Brule2, L Rozendaal2, FJ Voorhorst3, EKJ Risse2, RHM Verheijen4 and TJM Helmerhorst1 1Department of Obstetrics and Gynaecology, University Hospital Rotterdam, PO Box 2040, 3000 CA, Rotterdam, 2Department of Pathology, 3Department of Clinical Epidemiology and Biostatistics, 4Department of Obstetrics and Gynaecology, University Hospital Vrije Universiteit, PO Box 7057, 1007 MB, Amsterdam, The Netherlands Summary We assessed a possible role for high-risk human papillomavirus (HPV) testing in the policy after treatment for cervical intraepithelial neoplasia (CIN) 2 or 3 (moderate to severe dysplasia). According to the Dutch guidelines follow-up after treatment consists of cervical cytology at 6, 12 and 24 months. Colposcopy is only performed in case of abnormal cervical cytology. In this observational study 184 women treated for CIN 2 or 3 were prospectively monitored by cervical cytology and high-risk HPV testing 3, 6, 9, 12 and 24 months after treatment. Post-treatment CIN 2/3 was present in 29 women (15.8%). A positive high-risk HPV test 6 months after treatment was more predictive for post-treatment CIN 2/3 than abnormal cervical cytology (sensitivity 90% and 62% respectively, with similar specificity). At 6 months the negative predictive value of a high-risk HPV negative, normal smear, was 99%.
    [Show full text]
  • Unsatisfactory Smears
    Normal cervix after application of acetic acid Cervical Ectropian Nabothian follicles The Post Menopausal cervix Cervical Polyp Cervical Warts Satisfactory With evidence of TZ sampling TZ – Squamous Metaplastic cells Transformation zone Acute Herpes Infection Herpes Simplex Strawberry Cervix Trichomonas Vaginalis Candida infection Actinomyces Threadworm ova Fibroid polyp Unsatisfactory smears • 2% • Can we reduce the incidence? Unsatisfactory • Scanty cellular material • Heavy blood staining • Cellular material obscured by debris or polymorphs • Lubricating gel in excess • Patient identity problem • Progesterone only contraception • Thin Prep pot past expiry date SMEAR TAKING • Always employ good technique • The cervix must be visualised • Any specimen with abnormal cells is by definition satisfactory for evaluation Bacteria and debris Mucus Atrophy • Range of speculum sizes available • Possible to give topical vaginal oestrogen for a week or two before attempting repeat smear if atrophy and dryness a problem Lubricant • Lubricants containing carbomers or carbopol polymers are prone to interfere with liquid based cytology • BSCC Guidelines recommend that if lubrication of the speculum is required a little warm water should be adequate. • Only use a small amount of a water soluble lubricant if absolutely necessary Lubricant Lubricant Lubricant Lubricant Lubricant • Patient Identity Problem automatically returned as unsatisfactory Risk factors for cervical neoplasia • Human Papilloma Virus especially oncogenic strains eg HPV 16,18,32 • Smoking
    [Show full text]
  • Terminology in Gynaecological Cytopathology: Report of the Working Party of the British Society for Clinical Cytology
    J Clin Pathol: first published as 10.1136/jcp.39.9.933 on 1 September 1986. Downloaded from J Clin Pathol 1986;39:933-944 Review article Terminology in gynaecological cytopathology: report of the Working Party of The British Society for Clinical Cytology D M D EVANS (CHAIRMAN),* E A HUDSON (SECRETARY),t C L BROWN,tt M M BODDINGTON,¶T H E HUGHES,¶ E F D MACKENZIE,** T MARSHALL§ From *St David's Hospital, Cardiff, tNorthwick Park Hospital, Harrow, ttThe London Hospital, ¶Royal Berkshire Hospital, Reading, ¶Glasgow Royal Infirmary. **Southmead General Hospital, Bristol, §Central Pathology Laboratory, Stoke on Trent SUMMARY The report defines and recommends terms for use in cervical cytology. Most cervical smear reports are received by medical firm prediction of CIN 3 because the cytologist can- practitioners who do not have specialised knowledge not reliably exclude a microinvasive or invasive of pathology or gynaecology. Therefore it is lesion. The histological prediction is more accurately important that the report is not only scientifically recorded on the National Cytology Form, HMR accurate but also easily understood so that the patient 101/5 (1982), where severe dysplasia or carcinoma in copyright. receives appropriate management and advice. To situ-(C-IN 3), or-carcinoma in situ (CIN 3) or? invasive promote these aims the British Society for Clinical carcinoma are the alternatives provided. Cytology set up a working party to make recommen- dations on the reporting of cervical smears and the INFLAMMATORY NUCLEAR CHANGES AND terms used. It was suggested that common use of a DYSKARYOSIS small but clearly defined vocabulary would improve A continuous range of nuclear abnormalities occurs, the communication of results to users of the cytology from minor changes that are usually associated with services and provide an accurate basis for wider inflammatory conditions and which are believed to be reference.
    [Show full text]
  • Evidence Synthesis Number 158 Screening for Cervical Cancer With
    Evidence Synthesis Number 158 Screening for Cervical Cancer With High-Risk Human Papillomavirus Testing: A Systematic Evidence Review for the U.S. Preventive Services Task Force Prepared for: Agency for Healthcare Research and Quality U.S. Department of Health and Human Services 5600 Fishers Lane Rockville, MD 20857 www.ahrq.gov Contract No. HHSA-290-2012-00015-I-EPC4, Task Order No. 6 Prepared by: Kaiser Permanente Research Affiliates Evidence-based Practice Center Kaiser Permanente Center for Health Research Portland, OR Investigators: Joy Melnikow, MD, MPH Jillian T. Henderson, PhD Brittany U. Burda, DHSc, MPH Caitlyn A. Senger, MPH Shauna Durbin, MPH Meghan A. Soulsby, MPH Jamie H. Thompson, MPH AHRQ Publication No. 17-05231-EF-1 September 2017 This report is based on research conducted by the Kaiser Permanente Research Affiliates Evidence-based Practice Center (EPC) and the University of California, Davis Center for Healthcare Policy and Research under contract to the Agency for Healthcare Research and Quality (AHRQ), Rockville, MD (Contract No. HHSA-290-2012-00015-I-EPC4, Task Order No. 6). The findings and conclusions in this document are those of the authors, who are responsible for its contents, and do not necessarily represent the views of AHRQ. Therefore, no statement in this report should be construed as an official position of AHRQ or of the U.S. Department of Health and Human Services. The information in this report is intended to help health care decisionmakers—patients and clinicians, health system leaders, and policymakers, among others—make well-informed decisions and thereby improve the quality of health care services.
    [Show full text]
  • Laboratory Diagnosis of Human Papillomavirus Virus Infection in Female Genital Tract
    Resident’s Page Laboratory diagnosis of human papillomavirus virus infection in female genital tract Rahul Dixit, Chintan Bhavsar, Y. S. Marfatia Department of Skin VD,Government Medical College and SSG Hospital,Vadodara, Gujarat, India Address for correspondence: Dr. YS. Marfatia, Department of Skin VD, Government Medical College and SSG Hospital, Vadodara, Gujarat, India. E-mail: [email protected] INTRODUCTION spreading the virus. Asymptomatic HPV/DNA shedding from perianal region seems to be very common, 78.9% A human papillomavirus (HPV), a member of the in AIDS patients with advanced disease stage.[4] papillomavirus, is a double-stranded DNA virus and produces cytopathic effect in epithelium. Genital There was no consistent evidence that condom use mucosal infection is persistent and multifocal and reduces the risk of becoming HPV DNA – positive can be subclinical. (subclinical HPV infection). On the other hand, the risk for genital warts, CIN 2-3 and invasive cervical cancer More than 30 to 40 types of HPV are typically were reduced by condom use.[5] transmitted through sexual contact and infect the [1] anogenital region. Some sexually transmitted HPV LAB DIAGNOSIS types may cause genital warts. Persistent infection with "high-risk" HPV types different from the ones The traditional methods of viral diagnosis such that cause skin warts, may progress to precancerous as electron microscopy, cell culture, and certain lesions and invasive cancer.[2] HPV infection is a immunological methods are not suitable for HPV cause of nearly all cases of cervical cancer;[3] however, detection. HPV cannot be cultured in cell cultures. most infections with these types do not cause disease.
    [Show full text]
  • Hpv Handbook
    Prendiville Davies Prendiville THE HEALTH PROFESSIONAL’S HPV HANDBOOK 1: HUMAN PAPILLOMAVIRUS AND CERVICAL CANCER Editors-in-Chief THE HEALTH PROFESSIONAL’S HPVHANDBOOK 1 PROFESSIONAL’S THE HEALTH Professor Walter Prendiville Coombe Women’s Hospital, Dublin, Ireland Dr Philip Davies European Consortium for Cervical Cancer Education, London, UK 2 Park Square, Milton Park, Abingdon, Oxon OX14 4RN 270 Madison Avenue, New York NY 10016 www.tandf.co.uk THE HEALTH PROFESSIONAL’S HPV HANDBOOK 1: HUMAN PAPILLOMAVIRUS AND CERVICAL CANCER Editors-in-Chief Professor Walter Prendiville Coombe Women’s Hospital, Dublin, Ireland Dr Philip Davies European Consortium for Cervical Cancer Education, London, UK THE HEALTH PROFESSIONAL’S HPV HANDBOOK 1: HUMAN PAPILLOMAVIRUS AND CERVICAL CANCER Editors-in-Chief Professor Walter Prendiville Coombe Women’s Hospital, Dublin, Ireland Dr Philip Davies European Consortium for Cervical Cancer Education, London, UK © 2004 The European Consortium for Cervical Cancer Education First published in the United Kingdom in 2004 by Taylor & Francis, an imprint of the Taylor & Francis Group, 2 Park Square, Milton Park Abingdon, Oxon OX14 4RN, UK Tel.: +44 (0) 20 7017 6000 Fax.: +44 (0) 20 7017 6069 Website: www.tandf.co.uk All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without the prior permission of the publisher or in accordance with the provisions of the Copyright, Designs and Patents Act 1988 or under the terms of any licence permitting limited copying issued by the Copyright Licensing Agency, 90 Tottenham Court Road, London W1P 0LP.
    [Show full text]
  • Effects of PI3K and FGFR Inhibitors on Human Papillomavirus Positive and Negative Tonsillar and Base of Tongue Cancer Cell Lines
    Effects of PI3K and FGFR Inhibitors on Human Papillomavirus Positive and Negative Tonsillar and Base of Tongue Cancer Cell Lines Birthe Katrin Alexandra Lange __________________________________________ Master Degree Project in Medical Research, 30 credits. Spring 2019 Department: Oncology-Pathology, Karolinska Institutet Supervisor: Prof. em. Tina Dalianis; Dr. Stefan Holzhauser UPPSALA UNIVERSITET FGFR and PI3K inhibitors in oropharyngeal cancer 2 (31) Abstract Background: The standard treatment, chemoradiotherapy, for patients with human papillomavirus positive (HPV+) and negative (HPV-) tonsillar and base of tongue squamous cell carcinomas (TSCC, BOTSCC) is similar although their sensitivities to therapy vary considerably. It is too harsh for many patients with HPV+ but too weak for some patients with HPV- tumours. PIK3CA and FGFR3 are mutated in fractions of TSCC and BOTSCC patients and represent possible therapy targets. Aim: To test the effects of PI3K and FGFR inhibitors as single and combination treatments on TSCC and BOTSCC cell lines. Methods: HPV- TSCC UT-SCC-60A and HPV+ BOTSCC UPCI-SCC-154 cells were treated with the PI3K/mTOR inhibitor BEZ235 (0.25 µM to 5 µM) and FGFR inhibitor AZD4547 (5 µM to 50 µM). The WST-1 assay, CellTox Green Cytotoxicity assay, Caspase-Glo 3/7 assay and xCELLigence RTCA DP instrument were used to evaluate the treatments regarding viability, cytotoxicity, apoptosis and proliferation. Results: UT-SCC-60A cells were sensitive to treatment with the highest tested doses of BEZ235 and AZD4547, while UPCI-SCC-154 cells were more sensitive to both inhibitors. Combinations of the inhibitors resulted in larger treatment effects in both cell lines. Conclusions: Combinations of BEZ235 and AZD4547 for treatment of UT-SCC-60A and UPCI-SCC- 154 cells were superior compared with single treatments, to which UT-SCC-60A cells were less sensitive than UPCI-SCC-154 cells.
    [Show full text]
  • The Prevalence of Wart Virus Infection and Its Association with Pre-Malignant Lesions of the Cervix
    931 THE PREVALENCE OF WART VIRUS INFECTION AND ITS ASSOCIATION WITH PRE-MALIGNANT LESIONS OF THE CERVIX GEETA SINHA SUMMARY The genital wart vit·us can pt·oduce flat lesions on the cervix which are diflicult to distinguish colposcopically or cytologically ft·om dysplasia. The peri-nuclear vaculation seen in the epithelial cells, called Koilocytes is a cytopathic effect of the wart virus. This is evident on cet·vical sc.-ape smear stained by Papanicolaou method. Cytological and histological evidence of cervical H.P.V. (Human Papilloma Vims) infection is being reported with inct·easing frequency. There is a great deal of cit·cumstantial evidence incriminating H.P.V. in genital tract carcinogenesis. This study was done to tind out the prevalence of wart virus infection (W. V.I.) in cenical smear of women attending ~ the out-patients clinic of Patna Medical College and Hospital. Out of a total of 500 cases, 34 (6.8%) had evidence of wart virus infection cytologically, whereas out of the dyskaryotic smeat·s 20.8% had evidence of ·W. V.I. INTRODUCTION can produce flat lesions on the cervix Human warts arc caused by the human (apart from the typical condylomata papilloma virus (H.P.V.), a small acuminata), which are difficult to distin­ encogenic D.N.A. virus of the PAPOVA guish colposcopically or cytologically from viridae family. They can not be as yet dysplasia. It produces the characteristic propagated to vitro. The genital wart virus histological changes of Koilocytosis, multi nucleation and dyskeratosis (Kirk­ Dept. of Obst. &: Gyn. Patna Medical College & Hospital, Patna.
    [Show full text]
  • Human Papillomavirus (HPV) Testing Comes to the NHS Cervical Screening Programme
    J Fam Plann Reprod Health Care: first published as 10.1136/jfprhc.2011.0100 on 31 March 2011. Downloaded from Commentary Ushering in a new era: human papillomavirus (HPV) testing comes to the NHS Cervical Screening Programme Anne Szarewski Centre for Cancer Prevention, Background could automatically have an HPV test per- Wolfson Institute for Preventive The National Health Service Cervical formed on their sample, without the need Medicine, Queen Mary, University of London, London, UK Screening Programme (NHSCSP) has for the woman to be re-examined. If high- announced that from April 2011, human risk HPV is found they will be referred for Correspondence to papillomavirus (HPV) testing will be colposcopy; if HPV is not found they will Dr Anne Szarewksi, Centre for incorporated into the national screening be returned to routine screening. Cancer Prevention, Wolfson Institute for Preventive Medicine, programme in England. Initially, HPV Why has the NHSCSP chosen to use Queen Mary, University of testing will be used for the triage of bor- triage in the management of women with London, Charterhouse Square, derline and mildly dyskaryotic smears, but mild, as well as borderline, dyskaryosis? London EC1M 6BQ, UK; there are also plans, at a later date, for its The American College of Obstetrics and [email protected] use as a ‘test of cure’ following treatment Gynecology published guidelines on the 1 Received 10 February 2011 for cervical abnormalities (Figure 1). It use of HPV triage in 2009, but only rec- Accepted 17 February 2011 would have been interesting to see the ommended its use in women with atypical data underpinning the proposals, but no squamous cells of unknown significance references were given.
    [Show full text]