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dc.contributor.authorLeeson, Simon C
dc.contributor.authorAlibegashvili, Tamar
dc.contributor.authorArbyn, Marc
dc.contributor.authorBergeron, Christine
dc.contributor.authorCarriero, Carmine
dc.contributor.authorMergui, Jean-Luc
dc.contributor.authorNieminen, Pekka
dc.contributor.authorPrendiville, Walter
dc.contributor.authorRedman, Charles W E
dc.contributor.authorRieck, Gudrun C
dc.contributor.authorQuaas, Jens
dc.contributor.authorPetry, K Ulrich
dc.date.accessioned2014-11-18T14:53:14Z
dc.date.available2014-11-18T14:53:14Z
dc.date.issued2014-01
dc.identifier.citationLeeson, S.C. et al., 2014. HPV testing and vaccination in Europe. Journal of Lower Genital Tract Disease, 18 (1) pp 61-9en_GB
dc.identifier.issn1526-0976
dc.identifier.pmid23774078
dc.identifier.doi10.1097/LGT.0b013e318286b8d3
dc.identifier.urihttp://hdl.handle.net/10147/335772
dc.description.abstractCurrent cytology-based screening has a moderate sensitivity to detect cervical intraepithelial neoplasia grade 3 (CIN 3) and cervical cancer even in those states providing rigorous quality control of their cervical screening programs. The impact of vaccination against human papillomavirus (HPV) types 16 and 18 as well as the incorporation of HPV testing on the detection of CIN 3 and cancer is discussed. HPV testing used as a triage for atypical squamous cells of undetermined significance (ASCUS) and low-grade squamous intraepithelial lesions, test of cure after treatment, and HPV-based primary screening may improve current cervical screening programs.HPV testing as a triage test for ASCUS seems to offer an improved sensitivity, with a similar specificity as compared to repeat cytology for diagnosing high-grade CIN and has been recommended throughout most EU states. HPV testing as a triage test for low-grade squamous intraepithelial lesions has a low specificity and is not recommended in most member states. HPV test of cure offers an improved sensitivity compared to cytology for women with persistent cervical precancer after treatment. HPV-based cervical cancer screening is more effective than screening with cytology. The effects of HPV-based screening depend on the organization of the program and on adherence to algorithms for screening triage. Otherwise, it is likely that HPV-based screening will increase the referral rate to colposcopy including more women with no detectable cervical lesion. HPV vaccination will require many years to evaluate any beneficial effects on cervical cancer incidence and mortality.
dc.language.isoenen
dc.rightsArchived with thanks to Journal of lower genital tract diseaseen_GB
dc.subjectCERVICAL CANCERen_GB
dc.subjectIMMUNISATIONen_GB
dc.subject.meshEarly Detection of Cancer
dc.subject.meshEurope
dc.subject.meshFemale
dc.subject.meshHuman Papillomavirus DNA Tests
dc.subject.meshHumans
dc.subject.meshPapillomaviridae
dc.subject.meshPapillomavirus Infections
dc.subject.meshPapillomavirus Vaccines
dc.subject.meshUterine Cervical Neoplasms
dc.subject.meshVaccination
dc.titleHPV testing and vaccination in Europe.en_GB
dc.typeArticleen
dc.contributor.department1Department of Obstetrics and Gynaecology, Betsi Cadwaladr University Health Board, Bangor, Gwynedd, UK; 2Department of Gynecology, National Screening Center, Tbilisi, Georgia; 3Unit of Cancer Epidemiology, Scientific Institute of Public Health, Brussels, Belgium; 4Laboratoire Cerba, Paris, France; 5Department of Gynecology and Obstetrics, University of Bari, Bari, Italy; 6Hôpital Tenon, Service de Gynécologie Obstétrique et Médecine de la Reproduction, Paris, France; 7Department of Obstetrics and Gynecology, Helsinki University Hospital, Finland; 8The Beacon Hospital, Sandyford, Dublin, Ireland; 9Department of Obstetrics and Gynaecology, University Hospital of North Staffordshire, Stoke-on-Trent, UK; 10D-18437 Stralsund, Grünthal, Germany; and 11Department of Obstetrics and Gynaecology, Klinikum Wolfsburg, Wolfsburg, Germany.en_GB
dc.identifier.journalJournal of lower genital tract diseaseen_GB
dc.description.fundingNo fundingen
dc.description.provinceLeinsteren
dc.description.peer-reviewpeer-reviewen
html.description.abstractCurrent cytology-based screening has a moderate sensitivity to detect cervical intraepithelial neoplasia grade 3 (CIN 3) and cervical cancer even in those states providing rigorous quality control of their cervical screening programs. The impact of vaccination against human papillomavirus (HPV) types 16 and 18 as well as the incorporation of HPV testing on the detection of CIN 3 and cancer is discussed. HPV testing used as a triage for atypical squamous cells of undetermined significance (ASCUS) and low-grade squamous intraepithelial lesions, test of cure after treatment, and HPV-based primary screening may improve current cervical screening programs.HPV testing as a triage test for ASCUS seems to offer an improved sensitivity, with a similar specificity as compared to repeat cytology for diagnosing high-grade CIN and has been recommended throughout most EU states. HPV testing as a triage test for low-grade squamous intraepithelial lesions has a low specificity and is not recommended in most member states. HPV test of cure offers an improved sensitivity compared to cytology for women with persistent cervical precancer after treatment. HPV-based cervical cancer screening is more effective than screening with cytology. The effects of HPV-based screening depend on the organization of the program and on adherence to algorithms for screening triage. Otherwise, it is likely that HPV-based screening will increase the referral rate to colposcopy including more women with no detectable cervical lesion. HPV vaccination will require many years to evaluate any beneficial effects on cervical cancer incidence and mortality.


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