Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary, University of London, Charterhouse Square, London, EC1M 6BQ.
J Med Screen. 2013 Jun;20(2):99-103. doi: 10.1177/0969141313492313. Epub 2013 Jun 12.
Human papillomavirus (HPV) testing is being considered as the primary screening test for cervical cancer in England, rather than the currently used cytology test. We aimed to estimate the impact of primary HPV testing on incidence and morbidity of cervical cancer in England by estimating the proportion of cervical cancer diagnosed within 6 years of a negative cytology. We used a population-based case-control study of prospectively recorded data on cervical screening in England between 1988 and 2012, including 8774 women with invasive cervical cancer aged 25 to 64 and 17,341 controls. We used incidence rates in 2010 to estimate absolute risks. We found that 38.8% of all women with cervical cancer had a negative test within 6 years of diagnosis. Assuming HPV testing is 95% sensitive for cancers that would develop over the next 6 years but were missed by cytology, and that 4.3% of those diagnosed by cytology would be missed by HPV testing, we estimate that a maximum of 32.6% of current cases in women invited for screening aged 25 to 64 could be prevented. This translates to a reduction in the rate of cervical cancer in this age group of 4.2 per 100,000 women per year in England, equivalent to 587 cancers.
人乳头瘤病毒（HPV）检测正被考虑作为英格兰宫颈癌的主要筛查试验，而非目前使用的细胞学检测。我们旨在通过估计在细胞学阴性后 6 年内诊断出的宫颈癌比例，来估算在英格兰进行初级 HPV 检测对宫颈癌发病率和发病情况的影响。我们使用了基于人群的病例对照研究，对 1988 年至 2012 年期间英格兰宫颈筛查的前瞻性记录数据进行了分析，其中包括 8774 名年龄在 25 至 64 岁之间患有浸润性宫颈癌的妇女和 17341 名对照者。我们使用 2010 年的发病率来估算绝对风险。我们发现，所有宫颈癌妇女中有 38.8%在诊断后 6 年内有过阴性检测。假设 HPV 检测对未来 6 年内发展的癌症有 95%的敏感性，但细胞学检测会漏掉一些癌症，并且细胞学检测诊断的 4.3%会被 HPV 检测漏掉，我们估计在接受 25 至 64 岁年龄组筛查的妇女中，目前病例中有最多 32.6%可能会被预防。这相当于英格兰该年龄组宫颈癌发病率每年每 10 万名妇女减少 4.2 例，相当于减少 587 例癌症。
