CHALLENGES OF FALSE POSITIVE CYTOLOGICAL RESULTS IN CERVICAL CANCER SCREENING: THE FUTURE PERSPECTIVE OF MORE RELIABLE TESTING METHODS
Introduction: Cervical dysplasia caused by human papillomavirus is a significant public health concern that might lead to cervical cancer, particularly in the developing world. The cervical cancer preventative screening program in Kazakhstan needs more sophisticated screening methods for improving early detection and management, which can ultimately reduce the burden of this disease on women's health.
Aim: The aim of this study was to elicit false positive results as a major shortcoming of a current screening method and to recommend more accurate testing algorithms.
Materials and Methods: Study design: Modelling study, encompassing a period between 2016-2023 in The Medical Centre Hospital of President’s Affairs Administration of the Republic of Kazakhstan, Astana, Kazakhstan. The diagnoses of cervical dysplasia based upon cytological and human papillomavirus (HPV) DNA tests were collected in a hospital database (Infomed) and further analysed through GraphPad software.
Results and discussions: HPV-negative tests occurred in 30.43% (2016), 45.45% (2017), 28.20% (2018), 42.5% (2019), 35.71% (2020), 32.14% (2021), 21.15% (2022), and 54.45% (2023) of the total amount of patients. Nevertheless, they were diagnosed with mild dysplasia. While screening saves lives, it's important to acknowledge that false positives are inevitable without optimisations, and excessive testing can lead to substantial harm, including unnecessary treatments and a burden on the healthcare system.
Conclusion: Improvements in specificity might lead to a reduction in false positive results and an increase in the accuracy of referrals for colposcopy. The utilization of dual-staining with p16/Ki-67 cytology appears promising as a biomarker-based method for determining further steps in cervical cancer screening.
Alisher Aitkaliyev1*, http://orcid.org//0009-0002-9624-2663
Nazira Bekenova1, http://orcid.org//0000-0002-3312-3299
Tamara Vochshenkova1, http://orcid.org//0000-0003-0935-6217
Balzhan Kassiyeva1, http://orcid.org//0000-0002-8452-7146
Serik Alibekov1
Nasrulla Shanazarov1, http://orcid.org//0000-0002-2976-259X
1 Medical Centre Hospital of President’s Affairs Administration of the Republic of Kazakhstan,
Science and gerontology Department, Astana, Republic of Kazakhstan.
1. Панферова Е.В. et al. Ранняя диагностика рака шейки матки на уровне первичной медико-санитарной помощи. Цитологический скрининг. 2016. P. 80-81
2. Brianti P. et al. Review of HPV-related diseases and cancers // New Microbiol. 2017. 40(2): 80-85.
3. Byun S.W. et al. Immunostaining of p16INK4a/Ki-67 and L1 capsid protein on liquid-based cytology specimens obtained from ASC-H and LSIL-H cases // International Journal of Medical Sciences, 2013. 10(12): 1602.
4. Cuschieri K., Wentzensen N. Human papillomavirus mRNA and p16 detection as biomarkers for the improved diagnosis of cervical neoplasia // Cancer Epidemiology Biomarkers & Prevention. 2008. 17(10): 2536-2545.
5. Dominguez-Bali A. et al. (067) False Positive Pap Smear as The First Sign of Genitourinary Syndrome of Menopause" // The Journal of Sexual Medicine 20 (Supplement_2): qdad061.063. 2023. pp 061-063
6. Fontham E.T. et al. Cervical cancer screening for individuals at average risk: 2020 guideline update from the American Cancer Society // CA: a cancer journal for clinicians. 2020. 70(5): 321-346.
7. Gravitt P.E. et al. A cohort effect of the sexual revolution may be masking an increase in human papillomavirus detection at menopause in the United States // The Journal of infectious diseases. 2013. 207(2): 272-280.
8. Grimes D.R. et al. Challenges of false positive and negative results in cervical cancer screening." medRxiv: 2020. pp. 2020-23
9. Huh W.K. et al. Use of primary high-risk human papillomavirus testing for cervical cancer screening: interim clinical guidance. Elsevier. 2015. 136: 178-182.
10. Insinga R.P. et al. Epidemiologic natural history and clinical management of Human Papillomavirus (HPV) Disease: a critical and systematic review of the literature in the development of an HPV dynamic transmission model // BMC infectious diseases 2009. 9(1): 1-26.
11. Isidean S.D., Franco E.L. Embracing a new era in cervical cancer screening // The Lancet. 2014. 383(9916): 493-494.
12. Koliopoulos G. et al. Cytology versus HPV testing for cervical cancer screening in the general population // Cochrane database of systematic reviews. 2017. (8). p. 1-102
13. McLaughlin-Drubin M.E., Munger K. Viruses associated with human cancer // Biochimica et Biophysica Acta (BBA)-Molecular Basis of Disease. 2008. 1782(3): 127-150.
14. Mirabello L. et al. The intersection of HPV epidemiology, genomics and mechanistic studies of HPV-mediated carcinogenesis, MDPI. 2018. Стр?
15. Moscicki A.B. et al. Rate of and risks for regression of CIN-2 in adolescents and young women // Obstetrics and gynecology. 2010. 116(6): 1373.
16. Petry K. U., et al. (2011). "Triaging Pap cytology negative, HPV positive cervical cancer screening results with p16/Ki-67 Dual-stained cytology." Gynecologic oncology 121(3): 505-509.
17. Plummer M. et al. Global burden of cancers attributable to infections in 2012: a synthetic analysis // The Lancet Global Health. 2016. 4(9): e609-e616.
18. Rachel Skinner S. et al. Progression of HPV infection to detectable cervical lesions or clearance in adult women: Analysis of the control arm of the VIVIANE study // International journal of cancer. 2016. 138(10): 2428-2438.
19. Rodríguez A.C. et al. Rapid clearance of human papillomavirus and implications for clinical focus on persistent infections // Journal of the National Cancer Institute. 2008. 100(7): 513-517.
20. Ronco G. et al. Efficacy of HPV-based screening for prevention of invasive cervical cancer: follow-up of four European randomised controlled trials // The Lancet. 2014. 383(9916): 524-532.
21. Rositch A.F. et al. Contributions of recent and past sexual partnerships on incident human papillomavirus detection: acquisition and reactivation in older women Cancer research. 2012. 72(23): 6183-6190.
22. Schiffman M. et al. Relative performance of HPV and cytology components of cotesting in cervical screening // JNCI: Journal of the National Cancer Institute. 2018. 110(5): 501-508.
23. Smith M., Canfell K. Impact of the Australian National Cervical Screening Program in women of different ages // Medical Journal of Australia. 2016. 205(8): 359-364.
24. Smith M.A. et al. Impact of the National Cervical Screening Programme in New Zealand by age: analysis of cervical cancer trends 1985–2013 in all women and in Māori women // Cancer Causes & Control. 2017. 28: 1393-1404.
25. Stanley M. Pathology and epidemiology of HPV infection in females // Gynecologic oncology. 2010. 117(2): S5-S10.
26. Tjalma W.A. et al. The impact on women’s health and the cervical cancer screening budget of primary HPV screening with dual-stain cytology triage in Belgium // European Journal of Obstetrics & Gynecology and Reproductive Biology 2017. 212: 171-181.
27. von Knebel Doeberitz M. New markers for cervical dysplasia to visualise the genomic chaos created by aberrant oncogenic papillomavirus infections // European journal of cancer. 2002. 38(17): 2229-2242.
28. Ziemke P., Marquardt K. Immunocytochemistry of p16 INK4a and Ki-67 as adjunctive method for routine gynecological cytology of mild and moderate dysplasia // Der Pathologe. 2013. 34: 323-328.
References: [1]
1. Panferova E.V. et al. Rannyaya diagnostika raka sheiki matki na urovne pervichnoi mediko-sanitarnoi pomoshchi. Tsitologicheskii skrining [Early diagnosis of cervical cancer at the primary health care level. Cytological screening]. 2016. Pp.80-81
Количество просмотров: 789
Категория статей:
Оригинальные исследования
Библиографическая ссылка
Aitkaliyev A., Bekenova N., Vochshenkova T., Kassiyeva B., Alibekov S., Shanazarov N. Challenges of false positive cytological results in cervical cancer screening: the future perspective of more reliable testing methods // Nauka i Zdravookhranenie [Science & Healthcare]. 2023, (Vol.25) 6, pp. 15-21. doi 10.34689/SH.2023.25.6.002Похожие публикации:
TRENDS IN MORBIDITY AND MORTALITY FROM CHRONIC HEART FAILURE IN ALMATY
СТРУКТУРНО-ФУНКЦИОНАЛЬНЫЕ ИЗМЕНЕНИЯ МИОКАРДА ПОСЛЕ АОРТОКОРОНАРНОГО ШУНТИРОВАНИЯ У ПАЦИЕНТОВ С ИЗБЫТОЧНОЙ МАССОЙ ТЕЛА НА РАЗНЫХ ЭТАПАХ РЕАБИЛИТАЦИИ
МЕДИКО – СОЦИАЛЬНЫЕ, ПСИХОЛОГИЧЕСКИЕ АСПЕКТЫ КАЧЕСТВА ЖИЗНИ БОЛЬНЫХ С ОСТРЫМ ПАНКРЕАТИТОМ
A COMPARATIVE ANALYSIS OF 24-HOUR DIETARY RECALLS AND FOOD FREQUENCY QUESTIONNAIRES ADMINISTERED SIMULTANEOUSLY IN THE KAZAKHSTANI POPULATION
ANALYSIS OF PATIENT SATISFACTION WITH THE QUALITY OF ORGANIZATION OF TREATMENT IN FOREIGN CLINICS