The Influence of Human Papillomavirus Genotypes on Visual Screening and Diagnosis of Cervical Precancer and Cancer. Issue 3 (July 2015)

• Record Type: Journal Article
• Authors: Jeronimo, Jose; Bansil, Pooja; Valdez, Melissa; Kang, Le-Ni; Zhao, Fang-Hui; Qiao, You-Lin; Chen, Wen; Zhang, Xun; Paul, Proma; Bai, Ping; Peck, Roger; Li, Jing; Chen, Feng; Stoler, Mark H.; Castle, Philip E.
• Is Part Of: Journal of lower genital tract disease. Volume 19:Issue 3(2015:Jul.)
• Publication Date: 2015-07
• Subjects: Generative organs, Female -- Diseases -- Periodicals; Cervix uteri -- Diseases -- Periodicals; Generative organs -- Diseases -- Periodicals; Sexually transmitted diseases -- Periodicals; 618.1
• DOI: 10.1097/LGT.0000000000000088
• Languages: English
• ISSNs: 1089-2591

Abstract

<abstract> <title> <x xml:space="preserve">Abstract</x> </title> <sec> <title>Objective</title> <p>To examine the influence of human papillomavirus (HPV) genotypes on the sensitivity of visual inspection with acetic acid (VIA) for screening, and colposcopy for diagnosis of cervical intraepithelial neoplasia grade 2 (CIN2) or more severe (CIN2+).</p> </sec> <sec> <title>Materials and Methods</title> <p>Women aged 25 to 65 years from China (n = 7, 541) were screened with 6 tests (<italic>care</italic>HPV and Hybrid Capture 2 on self- and clinician-collected specimens; HPV-16, HPV-18, HPV-45 E6 detection; and VIA). Biopsies from women with a diagnosis of CIN2+ underwent testing for 25 HPV genotypes using SPF10/LiPA. Human papillomavirus genotyping results were classified according to broad categories of cancer risk.</p> </sec> <sec> <title>Results</title> <p>Among the 143 women with a diagnosis of CIN2+, the percentage who were HPV16 positive increased with increasing severity of diagnosis: 33.3% for CIN2 (n = 39), 69.1% for CIN3 (n = 94), and 90% for cancer (n = 10). There was a higher percentage of HPV-16 in women with abnormal colposcopic impression (<italic>p</italic> = .007) and positive VIA (<italic>p</italic> = .02) than normal colposcopy and negative VIA, respectively. Colposcopy and VIA were more sensitive to detect CIN2+ among HPV-16– and/or HPV-18–positive women than HPV-16–/HPV-18–negative women (67.4% vs 43.1%, <italic>p</italic> = .008, for colposcopy; and 53.3% vs 37.3%, <italic>p</italic> = .08, for VIA).</p> </sec> <sec> <title>Conclusions</title> <p>Human papillomavirus type 16 is related to more clear visual acetowhite changes in the epithelium. Therefore, we should expect a reduction of the performance of VIA for cervical cancer screening to identify women with CIN2+, and reduction of the performance of colposcopy to diagnose CIN2+, in vaccinated populations.</p> </sec> </abstract>