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Screening for Cervical Cancer: A Systematic Evidence Review for the U.S. Preventive Services Task
Force. SEER website.. Published 2017. Accessed July 3, 2018. 9. U.S. Preventive Services Task
Force. The test is usually not painful but maybe a bit uncomfortable. Accuracy of colposcopy
management to detect CIN3 and invasive cancer in women with abnormal screening tests: results
from a primary HPV screening project from 2006 to 2011 in Wolfsburg, Germany. The high burden
of this disease necessitates identifying relevant evidence to inform policy development and
guidelines. Female-to-male patients have high prevalence of unsatisfactory Paps compared to non-
transgender females: implications for cervical cancer screening. Driven by this skepticism, the recent
paper by Rebolj et al. Previous Article in Journal Demographic and Clinical Features of Patients with
Metastatic Breast Cancer: A Retrospective Multicenter Registry Study of the Turkish Oncology
Group. The doctor will check your results and update you if any further steps need to be taken. With
time, sufficient reassuring data has accumulated regarding specially designed SS devices, aspects of
sample preparation, transport and storage and, importantly, optimization of validated PCR-based
HPV testing platforms for self-collected specimens. Cervical cancer is rare before age 21 years. 8
Exposure of cervical cells to hrHPV during vaginal intercourse may lead to cervical carcinogenesis,
but the process has multiple steps, involves regression, and is generally not rapid. Evidence from
RCTs, observational studies, and modeling studies suggest that a 5-year screening interval for
primary hrHPV testing alone or cotesting offers the best balance of benefits and harms. Screening
more frequently than every 5 years with primary hrHPV testing alone or cotesting does not
substantially improve benefit but significantly increases the number of screening tests and
colposcopies. The Pap-test includes scraping the outer opening of the cervix for cells and analysing
these under a microscope for any abnormalities. Paper should be a substantial original Article that
involves several techniques or approaches, provides an outlook for. Screening tests Screening with
cervical cytology alone, primary testing for hrHPV alone, or both at the same time (cotesting) can
detect high-grade precancerous cervical lesions and cervical cancer. Detection rates of precancerous
and cancerous cervical lesions within one screening round of primary human papillomavirus DNA
testing: prospective randomised trial in Finland. BMJ. 2012;345:e7789. 24. Zorzi M, Frayle H, Rizzi
M, et al; Veneto HPV-Screening Working Group. HPV-Based Self-Sampling in Cervical Cancer
Screening: An Updated Review of the Current Evidence in the Literature. Cancers. 2023;
15(6):1669. All disagreements (including those related to merging, screening, and selection of search
results) will be resolved in an open discussion between the two researchers. Published trials of
hrHPV testing used in situ hybridization, polymerase chain reaction, and hybrid capture technology
to test for HPV strains associated with cervical cancer. This pragmatic definition relies on
colposcopy as a reference standard, recognizing that there is variability in the accuracy of colposcopy
and biopsy. 19 False-negatives were defined as the proportion of invasive cervical cancer cases
occurring negative preceding screening results. The Newcastle-Ottawa Scale (NOS) for assessing the
quality of nonrandomised studies in meta-analysis. A 3-year interval is too short for re-screening
women testing negative for human papillomavirus: a population-based cohort study. BJOG.
2017;24(10):1585-1593. 25. Ronco G, Giorgi-Rossi P, Carozzi F, et al; New Technologies for
Cervical Cancer Screening Working Group. It is not until the cancer becomes invasive that symptoms
occur. The last surveillance was conducted on May 25, 2018, and resulted in the addition of the
initial results of the Compass trial. 12 The final results of the HPV FOCAL trial, published in JAMA
in July 2018, have also been incorporated in this review. 13. The first is liquid-based cytology, with
this method the cervix is scrapped with a small brush to collect cells. Grade: D Risk assessment All
women aged 21 to 65 years are at risk for cervical cancer because of potential exposure to hrHPV
types through sexual intercourse and should be screened. They estimated that for unvaccinated
cohorts, the health benefits of increased participation from SS would be outweighed by the worst-
case (2%) loss of relative test sensitivity, even for a marginally improved (15%) additional uptake. In
pragmatic terms, social distancing, local lockdowns, discontinuation of clinics and reallocation of
human and financial resources challenged established clinician-based screening; self-collection
strategies apparently surpassed most obstacles, representing a viable and flexible alternative.
Therefore, is it important that doctors inform their patients about this screening program and
emphasize that cervical cancer is largely preventable and that regular screening is the key to do this.
ISPRS International Journal of Geo-Information (IJGI).
BMC Cancer. 2014;14:574. 43. Petry KU, Luyten A, Scherbring S. Prognostic significance of
adenocarcinoma histology in women with cervical cancer. Please note that many of the page
functionalities won't work as expected without javascript enabled. Editor’s Choice articles are based
on recommendations by the scientific editors of MDPI journals from around the world. Use of
primary high-risk human papillomavirus testing for cervical cancer screening: interim clinical
guidance. Trials were heterogeneous for screening interval, number of rounds, and protocol. When
possible, results were also stratified by age (. HPV-Based Self-Sampling in Cervical Cancer
Screening: An Updated Review of the Current Evidence in the Literature. Cancers. 2023;
15(6):1669. If you need help with a non-urgent medical or admin request, you can now contact us
online. Journal of Low Power Electronics and Applications (JLPEA). In pragmatic terms, social
distancing, local lockdowns, discontinuation of clinics and reallocation of human and financial
resources challenged established clinician-based screening; self-collection strategies apparently
surpassed most obstacles, representing a viable and flexible alternative. A meta-analysis may not be
performed in case of bias, and differences in the included studies will be reported. Therefore, SS is
anticipated to reform the paradigm in cervical screening, underpinning systemic changes, internal
upgrades and robust quality assurance. 3. Discussion It is evident that several gaps in knowledge and
uncertainties still exist in SS implementation, mainly in establishing cost-effectiveness and defining
ideal triage strategies. Pap, mammography, and clinical breast examination screening among women
with disabilities: a systematic review. Lancet Oncol. 2009;10(7):672-682. 35. Kitchener HC, Canfell
K, Gilham C, et al. HPV is very common and transferred via sexual activity. Institutional Review
Board Statement Not applicable. The Pap-test includes scraping the outer opening of the cervix for
cells and analysing these under a microscope for any abnormalities. Population: Study was not
conducted in an included population. The opinions expressed in this document are those of the
authors and do not reflect the official position of AHRQ or the US Department of Health and
Human Services. It is caused by infection with the HPV that can affect the cells. The main
stakeholders, primary care providers tasked to communicate and offer SS, were poorly guided
regarding the pathology processes, availability, clinical management pathways for self-collection and
participant eligibility. This highlights the importance of regular screening for the disease.
Comparative effectiveness: Active comparator (eg, liquid-based cytology vs conventional cytology
alone). Only the NTCC Phase I trial reported age-stratified colposcopy and false-positive rates. The
merged records of the two researchers in Endnote will be assessed and duplicates removed. Risk
factors and other epidemiologic considerations for cervical cancer screening: a narrative review for
the U.S. Preventive Services Task Force. The Newcastle-Ottawa Scale (NOS) for assessing the
quality of nonrandomised studies in meta-analysis. J Natl Compr Canc Netw. 2014;12(3):333-341. 8.
Surveillance, Epidemiology, and End Results (SEER). All disagreements (including those related to
merging, screening, and selection of search results) will be resolved in an open discussion between
the two researchers.
Black women also had the highest mortality rate (3.7 deaths per 100,000 women). 8. Therefore, is it
important that doctors inform their patients about this screening program and emphasize that cervical
cancer is largely preventable and that regular screening is the key to do this. Most infections clear off
soon and they cause only mild changes. Second, the overall body of evidence was limited by trials
having no more than 2 and often only 1 randomized round of screening available for comparisons.
Prognostic significance of adenocarcinoma histology in women with cervical cancer. Human
papillomavirus testing for the detection of high-grade cervical intraepithelial neoplasia and cancer:
final results of the POBASCAM randomised controlled trial. Rockville, Md.: Agency for Healthcare
Research and Quality; 2018. No cases of invasive cervical cancer were detected. 48. Specifically, the
2 key questions (KQs) ( Figure 1 ) aimed to identify the benefits (KQ1) and harms (KQ2) of cervical
cancer screening using hrHPV screening alone as the initial test (primary screening) or paired with
cytology (cotesting), compared with screening with cytology as the primary test. A 3-year interval is
too short for re-screening women testing negative for human papillomavirus: a population-based
cohort study. BJOG. 2017;24(10):1585-1593. 25. Ronco G, Giorgi-Rossi P, Carozzi F, et al; New
Technologies for Cervical Cancer Screening Working Group. This article is an open access article
distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (
). This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced
in any medium, whether now known or later invented, except as authorized in writing by the AAFP.
AHRQ publication 11-05156-EF-1. 12. Canfell K, Caruana M, Gebski V, et al. American Cancer
Society, American Society for Colposcopy and Cervical Pathology, and American Society for
Clinical Pathology screening guidelines for the prevention and early detection of cervical cancer. SS
implementation has been globally boosted during the COVID-19 pandemic. The high burden of
cervical cancer in Nepal, calls for scientific evidence to guide the development of appropriate
interventions to increase cervical cancer screening coverage. The main stakeholders, primary care
providers tasked to communicate and offer SS, were poorly guided regarding the pathology
processes, availability, clinical management pathways for self-collection and participant eligibility.
Most are readily available commercially; despite not currently being FDA-approved, several have
been validated in the framework of the VALHUDES protocol. Clinical trial evidence and modeling
suggest that different triage protocols have generally similar detection rates for CIN 2 and CIN 3;
however, proceeding directly to diagnostic colposcopy without additional triage leads to a much
greater number of colposcopies compared with using other triage protocols. More than 50% of
women diagnosed with cervical cancer in the United States have not been screened in the prior 3 to 5
years. 56 The highest proportions of unscreened women are those without insurance (23.1%) or no
regular clinician (25.5%). 57. The ACS recognizes that primary HPV testing is not yet widely
available and may not yet be cost-efficient; however, the ACS is advocating primary HPV testing as
the preferred mechanism of testing as it has proven to be highly sensitive in detecting cervical
precancer and cancer. Subscribe to receive issue release notifications and newsletters from MDPI
journals. Int J Gynecol Cancer. 2008;18(4):743-748. 33. Kitchener HC, Almonte M, Gilham C, et al;
ARTISTIC Trial Study Group. Aside from catch-up screening, self-sampling has established a
continuing role in increasing cervical cancer screening uptake and scaling coverage globally. Self-
collected HPV testing improves participation in cervical cancer screening: a systematic review and
meta-analysis. Each researchers will independently perform these activities. Discrepancies were
resolved through consensus and consultation with a third investigator when required. By identifying
the generally low rate of clinical f-u after a positive SS screening result as a cause for concern, the
meta-analysis of Yeh et al. HPV testing in combination with liquid-based cytology in primary
cervical screening (ARTISTIC): a randomised controlled trial. The potential differentiation of self-
collection protocols for vaccinated versus non-vaccinated individuals also represents an open issue.