My Pico question:
P: Women between 18-69 years presenting for cervical cytology screening.
I: HPV DNA testing
C: Cytology Screening
O: Sensitivity for detecting cervical precancerous lesions.
Article 1:
Int J Cancer. 2014 Jul 1;135(1):166-77. doi: 10.1002/ijc.28640. Epub 2014 Jan 24.
Is HPV DNA testing specificity comparable to that of cytological testing in primary cervical cancer screening? Results of a meta-analysis of randomized controlled trials.
Pileggi C1, Flotta D, Bianco A, Nobile CG, Pavia M.
Author information
Abstract
Human-papillomavirus (HPV) DNA testing has been proposed as an alternative to primary cervical cancer screening using cytological testing. Review of the evidence shows that available data are conflicting for
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SEARCH METHODS:
We made a comprehensive literature search that included the Cochrane Register of Diagnostic Test Accuracy Studies; the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library), MEDLINE (through PubMed), and EMBASE (last search 6 January 2011). Selected journals likely to contain relevant papers were handsearched from 1992 to 2010 (December). We also searched CERVIX, the bibliographic database of the Unit of Cancer Epidemiology at the Scientific Institute of Public Health (Brussels, Belgium) which contains more than 20,000 references on cervical cancer.More recent searches, up to December 2012, targeted reports on the accuracy of triage of ASCUS or LSIL with other HPV DNA assays, or HPV RNA assays and other molecular markers. These searches will be used for new Cochrane reviews as well as for updates of the current review.
SELECTION CRITERIA:
Studies eligible for inclusion in the review had to include: women presenting with a cervical cytology result of ASCUS or LSIL, who had undergone both HC2 testing and repeat cytology, or HC2 testing alone, and were subsequently subjected to
What is the Human Papillomavirus? Commonly known as HPV, it is an infection that spreads through sexual contact. There are over one hundred different types of HPV; several types cause genital warts, while other high risk strands can lead to cancer of the cervix, anus, vagina, and penis. Because HPV is often asymptomatic, many people are unaware of their infection status, and thus, their potential for transmitting the virus to a sexual partner. The significance of the Human Papillomavirus is that fifty percent of Americans who are sexually active will contract it within their lives, and at any given point there are twenty million Americans already infected with it (“By the numbers: HPV Vaccine”).
You may be screened for cervical cancer more often if you have risk factors for cervical cancer
The U.S. Preventative Services Task Force (USPSTF) recommends cervical cancer screening with cytology testing (also known as a Pap Smear) every three years in women ages 21 to 65 (U.S. Preventative Services Task Force [USPSTF], 2016a). The USPSTF has graded this recommendation with an “A” indicating that they have a high level of certainty that the screening will prove to be beneficial, rather than harmful to the patient (USPSTF, 2016a). However, if this patient would prefer to receive cervical cancer screening every five years, the USPSTF also has a high level of certainty that this will prove to beneficial rather than harmful if human papillomavirus (HPV) and cytology are both performed during this screening (USPSTF, 2016a). The
Cervical Cancer Early Detection Program Journal of Women’s Health 20(10):1479-84 doi: 10.1089/jwh.2010.2530. Epub 2011 Jul 20
The most common sexually transmitted infection (STI) is human papillomavirus (HPV) (CDC, 2013). Over half of sexually activity people will become infected with HPV at some point in their lifetime (National Cancer Institute, 2012). HPV can fall into two categories: low-risk HPV and high-risk HPV (National Cancer Institute, 2012). Low-risk HPV, also known as HPV types 6 and 11, cause about 90% of genital warts (National Cancer Institute, 2012). High-risk HPV, also known as HPV types 16 and 18, causes about 70% of cervical cancer (National Cancer Institute, 2012).
Prophylactic vaccination against high risk human papilloma virus 16 and 18 represents an exciting means of protection against HPV related malignancy. However, this strategy alone, even if there is a level of cross protection against other oncogenic viruses, cannot completely prevent cervical cancer. In some countries cervical screening programs have reduced the incidence of invasive cervical cancer by up to 80 percent although this decline has now reached a plateau with current cancers occurring in patients who have failed to attend for screening or where the sensitivity of the tests have proved inadequate. Cervical screening is inevitably associated with significant anxiety for the many women who require investigation and treatment following abnormal cervical cytology. However, it is vitally important to stress the need for continued cervical screening to complement vaccination in order to optimize prevention in vaccines and prevent cervical cancer in older women where the value of vaccination is currently unclear. It is likely that vaccination will ultimately change the natural history of HPV disease by reducing the influence of the highly oncogenic types HPV 16 and 18. In the long term this is likely to lead to an increase in recommended screening intervals. HPV vaccination may also reduce
Almost all cervical carcinomas are caused by Human papillomavirus (HPV). Cervical cancer can be a life-threating disease. However, over recent years the occurrence of cervical cancer has declined as well as the chance of dying from it. A huge contributing factor to this decline is the importance of a regular pap smear. A pap smear can find cervical pre-cancer before it turns into cancer. Recently, a vaccine for HPV, has been on the market, which provides close to a 100% protection against pre-cancer and general warts. HPV and cervical cancer are two disease that are closely related. However, each disease effects not only similar populations, but also different populations, as well as having its own signs and symptoms, detection procedures,
The symptoms of cervical cancer are not always obvious thus the introduction of NHS cervical screening programme. The aim of the NHS Cervical Screening Programme is prevent the number women who die from cervical cancer each year due to not having early diagnoses. Since the introduction of the programme, a report was done between the NHS Cervical Screening Programme and Trent Cancer Registry it found that “Incidence and mortality rates in England have fallen considerably over the past 20 years. During this period, incidence rates decreased by over a third and mortality rates reduced by 60%. Survival, following a diagnosis of cervical cancer has improved in England since the 1980’s from the 83% to 88%”. (NHS, 2012, pp. P10-11).
HPV is the number one sexually transmitted infection (STI) in the United States, and anyone who is sexually active is at risk of contracting the virus. HPV is transmitted through intimate skin-to-skin contact with someone who has the virus, and it is so common that most all sexually active men and women encounter a strain without ever knowing they’re infected (CDC). There are many strains of the HPV virus, some of which don’t cause cervical cancer. To help understand and classify the types of HPV, the terms low-risk and high-risk HPV are used. Some
By limiting the number of sexual partners one has, getting vaccinated, and using condoms, one can significantly reduce his or chances of contracting a high risk HPV that can cause a cancer(1). A study in Australia has proved the effectiveness of the vaccine. Nathan Seppa in his article, “HPV vaccination proves its worth in Australia” states that, "Those who received all three shots were 54 percent as likely as unvaccinated women to have precancerous cervical growth and two-thirds as likely to have other abnormal cervical cell growth”(2). This demonstrates that there are steps people can take to prevent contracting HPV and in turn prevent cancers associated with certain HPVs.
Did you know there is more of a link between cervical cancer and HPV than smoking and lung cancer? Cervical cancer is currently the fourth most common cancer in women and the second leading cause of death from cancer in women. Along with those statistics, human papillomavirus is the most common sexually transmitted viral disease amongst men and women worldwide. The prevalence of women having a strain of HPV that ultimately leads to or increases the chance of cervical cancer is highly relatable. What is pathophysiology, signs, symptoms, prevention, and treatments of this ailment? You might ask will be covered in the next few pages of this paper.
Human Papillomavirus (HPV) is a double -stranded deoxyribonucleic acid (DNA) virus that only infects humans with an attraction to both cutaneous and mucosal surfaces such as the cervix, anus, tonsil, and oropharynx (Clark, 2013). HPV is a type of oncogenic virus that goes into the cells and can cause several diseases. Over the years, research has surfaced connecting genital HPV to several types of cancer. There are over a hundred strains of HPV but the most high risk strains, 16 and 18, have been shown to cause vulvar, vaginal, anal, and the most concerning, cervical cancer (Chan, Ng, & Wong, 2012). Genital HPV
Early detection of cancer is key, and the Pap smear is a screening tool that not only identifies cancerous cells, but also precancerous cells (Jin, 2014). This screening tool can be uncomfortable, and may make the patient apprehensive. It would be essential for this author to educate the patient regarding testing importance. Pap Smears are recommended for young women aged 21 or greater (Jin, 2014). Annual screening is no longer recommended if the patient is engaging in a monogamous relationship, and has had no changes. Up until age 30, pap smears are recommended every three years. Afterward, they can continue to be given every three years or every five years with HPV testing in addition (Jin, 2014). Based on results, further testing may be indicated in order to determine an accurate
Among the many arguments for mandatory HPV vaccination, the foremost is that it is an important medical achievement and a major public health milestone. This vaccine has proven to be one-hundred percent effective in preventing the 4 HPV strains that are responsible for seventy percent of cervical cancers and ninety percent of genital warts. In addition, no serious side effects have been identified. Because this vaccine is a preventive measure, administration before onset of sexual activity is ideal; however, even females who have been sexually active can still benefit from this vaccination (Perkins et al., 2010). Nationally and internationally, the HPV vaccine will significantly reduce disease burden by reducing monetary and psychological costs of invasive procedures that remove precancerous and cancerous lesions. By combining vaccination with routine Pap smear screening, these public health efforts have the remarkable opportunity to eradicate cervical cancer (Ramet et al., 2011).
Three separate randomized controlled trials for cervical screening have been conducted among Indian women of the