Kotaniemi-Talonen Laura, Anttila Ahti, Malila Nea, Tarkkanen Jussi, Laurila Pekka, Hakama Matti, Nieminen Pekka
Mass Screening Registry, Finnish Cancer Registry, Liisankatu 21 B, FI-00170 Helsinki, Finland.
Eur J Cancer. 2008 Mar;44(4):565-71. doi: 10.1016/j.ejca.2007.12.002. Epub 2008 Jan 8.
To determine cross-sectional validity of primary human papillomavirus (HPV) screening in comparison to cytological screening.
During 2003-2004, 61,149 women were individually randomised to screening with a test for oncogenic HPV DNA or to conventional cytological screening within the Finnish cervical screening programme.
For HPV screening, cross-sectional relative sensitivity for cervical intraepithelial neoplasia (CIN) or cancer was 1.58 (95 % confidence interval 1.19-2.09) in comparison to cytology. At the level of CIN 3 or cancer no increase in relative sensitivity was observed. Cross-sectional specificity estimates for the screening arms were comparable, but the specificity of screening with sole HPV DNA test was clearly inferior.
Primary HPV screening with cytology triage finds more CIN lesions compared to conventional screening but mild lesions are overrepresented. This is likely to result in overdiagnosis since most mild lesions are regressive.
确定与细胞学筛查相比，原发性人乳头瘤病毒（HPV）筛查的横断面有效性。
在2003年至2004年期间，61149名女性被分别随机分配至芬兰宫颈癌筛查项目中，接受致癌性HPV DNA检测筛查或传统细胞学筛查。
对于HPV筛查，与细胞学相比，宫颈上皮内瘤变（CIN）或癌症的横断面相对敏感性为1.58（95%置信区间1.19 - 2.09）。在CIN 3或癌症水平，未观察到相对敏感性增加。筛查组的横断面特异性估计值相当，但仅进行HPV DNA检测筛查的特异性明显较低。
与传统筛查相比，采用细胞学分流的原发性HPV筛查发现更多CIN病变，但轻度病变占比过高。由于大多数轻度病变会自行消退，这可能导致过度诊断。
