Ang Joella Xiaohong, Tay Sun Kuie
Department of Obstetrics & Gynaecology, Singapore General Hospital, Singapore.
Cancer Control. 2025 Jan-Dec;32:10732748251336414. doi: 10.1177/10732748251336414. Epub 2025 Apr 24.
IntroductionWe evaluated the clinical efficacy of primary Human Papillomavirus (HPV) testing and liquid-based cytology (LBC) for cervical screening in women below 30 years old.MethodsThis was a retrospective analysis of data collected prospectively from women 25 years or older who attended hospital-based gynaecology clinics for cervical screening. Simultaneous high-risk HPV testing with partial genotyping and LBC testing was performed. Comparison of clinical efficacy of HPV testing and LBC was performed for routine screening discharge rate, colposcopy referral rate, and number of colposcopies needed for each CIN2+ detected.ResultsOf 6398 women included, 503 women (7.9%) tested positive for HPV DNA. The positivity was higher for 25-to-29 years old than for women ≥30 years old (12.6% vs 7.3%, < .001). The rate was markedly skewed by a low rate for women ≥45 years old. Similarly, more women below 30 years old (10.6%) had abnormal LBC results compared to women ≥30 years old (6.0%). Comparing LBC and HPV testing, the observed difference was not significant for discharge rate to interval screening (89.5% vs 87.4%). A higher referral to coloscopy rate (6.6 % vs 7.8%) was observed for HPV screening but the number of colposcopies for each detected CIN2+ (5 vs 7) was not significantly different. Clinical efficacy of HPV and LBC testing was similar in comparisons of women in 5-year groupings between 25 and 44 years old.ConclusionsOur data indicated that cervical screening for women between 25 and 29 years old could adopt HPV screening as the older women.
引言
我们评估了原发性人乳头瘤病毒(HPV)检测和液基细胞学检查(LBC)在30岁以下女性宫颈筛查中的临床疗效。
方法
这是一项对前瞻性收集的数据进行的回顾性分析,这些数据来自25岁及以上到医院妇科门诊进行宫颈筛查的女性。同时进行了高危HPV检测及部分基因分型和LBC检测。对HPV检测和LBC的临床疗效进行了比较,比较指标包括常规筛查出院率、阴道镜转诊率以及每例检测到的CIN2+所需的阴道镜检查次数。
结果
在纳入的6398名女性中,503名女性(7.9%)HPV DNA检测呈阳性。25至29岁女性的阳性率高于30岁及以上女性(12.6%对7.3%,P<0.001)。该比率因45岁及以上女性的低比率而明显偏态分布。同样,30岁以下女性LBC结果异常的比例(10.6%)高于30岁及以上女性(6.0%)。比较LBC和HPV检测,在间隔筛查出院率方面观察到的差异不显著(89.5%对87.4%)。HPV筛查的阴道镜转诊率较高(6.6%对7.8%),但每例检测到的CIN2+的阴道镜检查次数(5次对7次)差异不显著。在25至44岁的5年分组女性比较中,HPV和LBC检测的临床疗效相似。
结论
我们的数据表明,25至29岁女性的宫颈筛查可以采用与年长女性相同的HPV筛查方法。