Abstract
Recently, cervical cancer rates elevation has been noted in women aged 20–39 years in regions with a very high human development index (HDI). The onset of cancer elevation rates is observed in the age range of 25–29 years, which should necessitate effective precancer screening in younger age groups, including those <25 years. From 30.066 liquid-based screening tests results (n = 30.066), 3849 liquid-based cytology, 1321 high-risk human papillomavirus (HRHPV) and 316 p16/Ki67 performed in women <30 years were selected. Performance characteristics were calculated for three screening models: primary HRHPV with p16/Ki67 triage, primary cytology with reflex HPV and primary cytology alone. Primary HRHPV with p16/Ki67 triage was significantly more sensitive in high-grade squamous intraepithelial lesion quantified with cervical intraepithelial neoplasia grade 2 or worse [HSIL(CIN2+)] detection than cytology with reflex HRHPV and cytology alone (83.3% vs. 70.8%/45.8%) and had significantly higher diagnostic predictive values (PPV:29.4%/21.3%/22.9%; NPV:91.7%/82.9%/82.2%, respectively at CIN2+ threshold). The number of colposcopies per HSIL(CIN2+) detection indices was 3.4, 4.7 and 4.4, respectively. Primary HPV testing in women <30 years with p16/Ki67 triage of HPV-positive cases might be an effective cervical cancer screening strategy for HSIL(CIN2+) detection with superior diagnostic performance when compared with primary cytology-based models. Women <25 years might also benefit from an introduction to a more sensitive screening approach.
Highlights
The incidence and mortality of cervical cancer vary globally depending on the geographic region and the level of the human development index (HDI) [1]
There were three cervical cancer screening modalities used in the center over the period considered: cytology with reflex 14 high-risk types human papillomavirus test (HRHPV14), co-testing (HRHPV14 simultaneously performed with liquid-based cytology (LBC)) and co-testing plus
HRHPV14 and p16/Ki67 Results in Cytology Groups, No (% of liquid-based screening (LBS) Results for LBC Diagnosis Defined in the First Column)
Summary
The incidence and mortality of cervical cancer vary globally depending on the geographic region and the level of the HDI [1]. In countries with a very high HDI, there has been an increase in cervical cancer incidence in recent years, and this applies to women in the 20–39 age group [2], which is a worrying phenomenon. Human papillomavirus DNA testing is the globally recommended primary screening strategy for cervical cancer prevention for women 25–65 years old in all resource settings [6]. Whereas the European guidelines for quality assurance in cervical cancer screening strongly recommend the introduction of the primary HPV model in women aged 30 or above, even above 35 [12]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
