Schiffman Mark, de Sanjose Silvia
Division of Cancer Epidemiology and Genetics, National Cancer Institute, US National Institutes of Health, Bethesda, MD, 20892, USA.
Sexual and Reproductive Health Program, PATH, Seattle, 98121, USA; Ciber Epidemiologia y Salud Publica, Barcelona, Spain.
Papillomavirus Res. 2019 Jun;7:184-187. doi: 10.1016/j.pvr.2019.04.012. Epub 2019 Apr 25.
In cervical cancer screening, HPV testing is best at reassuring women when they are negative, but proper management of HPV positives is still evolving. Most HPV infections are benign, and over-reacting clinically to HPV positivity can cause psychological and possible iatrogenic physical (e.g., obstetrical) harm. We describe the built-in false positives in current tests, and the real harm that can result when the meaning of such false positive HPV tests is misunderstood. We suggest steps that could reduce harm being done by flawed tests and excessive clinical responses to positive HPV testing. We focus the discussion by presenting an illustrative case.
在宫颈癌筛查中,HPV检测在结果为阴性时最能让女性安心,但对HPV阳性结果的妥善管理仍在不断发展。大多数HPV感染是良性的,临床上对HPV阳性反应过度会造成心理伤害,还可能造成医源性身体伤害(如产科方面的)。我们描述了当前检测中固有的假阳性情况,以及当这种HPV检测假阳性的意义被误解时可能导致的实际危害。我们提出了一些措施,以减少有缺陷的检测以及对HPV检测阳性的过度临床反应所造成的危害。我们通过展示一个示例病例来集中讨论。