High-Risk HPV Testing in Primary Screening for Cervical Cancer in the Public Health System, Sao Paulo, Brazil

Author(s)

Levi, Jose Eduardo ^[1] ; Martins, Toni Ricardo ^{[2, 1]} ; Longatto-Filho, Adhemar ^{[2, 3, 4, 5]} ; Cohen, Diane Dede ^[6] ; Cury, Use ^[6] ; Fuza, Luiz Mario ^{[6, 1]} ; Villa, Luisa L. ^{[2, 7]} ; Eluf-Neto, Jose ^{[2, 6]}

Affiliation

^[1] Univ Sao Paulo, Inst Med Trop, Virol Lab LIM 52, Sao Paulo - Brazil

^[2] Univ Sao Paulo, Fac Med, Sao Paulo - Brazil

^[3] ICVS 3Bs PT Govt Associate Lab, Braga - Portugal

^[4] Barretos Canc Hosp, Mol Oncol Res Ctr, Sao Paulo - Brazil

^[5] Univ Minho, Sch Med, Life & Hlth Sci Res Inst ICVS, Braga - Portugal

^[6] Fundacao Oncoctr Sao Paulo, Sao Paulo - Brazil

^[7] Inst Canc Estado Sao Paulo, Sao Paulo - Brazil

• Document type: Journal article
• Source: Cancer Prevention Research; v. 12, n. 8, p. 539-546, AUG 2019.
• Web of Science Citations: 0

Abstract

Every year there are approximately 16,000 new cases of cervical cancer in Brazil. Novel screening technologies may reduce this number by expanding the population coverage but also by improving the detection rate of precursor lesions. We aimed to evaluate human papillomaviruses (HPV)-DNA testing in the context of routine cervical cancer screening in the public health system of the city of Sao Paulo, Brazil. Women participating in the primary screening program were invited to enroll. Liquid-based cytology samples were collected and cytology and Hr-HPV DNA testing were performed in parallel. Cytologists were blind to I IPV results. Women older than 24 years with a positive high-risk HPV test and/or cytology class >= ASC-US were referred to colposcopy. From December 2014 to December 2016, 16,102 women joined the study. High-risk human papillomavirus (HR HPV) DNA prevalence was 14.9%, whereas cytologic abnormalities were found in 7,2% of the women. Per protocol, 1,592 Hr-HPV+ women, in addition to 72 patients with cytologic classification > low-grade squamous intraepithelial lesion (LSIL) were referred. A total of 80 cervical intraepithelial neoplasia (CIN2(+)) cases were diagnosed, 79 were Hr-HPV DNA(+) and 18 had normal cytology. Hr-HPV DNA detected a significant number of patients with premalignant lesions missed by cytology and all 16 CIN3(+) cases were Hr-HPV DNA(+). HPV genotyping may be useful in the management of Hr-HPV+ women, reducing the burden of colposcopic referral for those harboring genotypes with a weaker association to CIN3(+). Use of HPV-DNA testing was shown to be feasible and advantageous over current cytologic screening in the public health system. (AU)

• FAPESP's process: 08/57889-1 - Institute of Science and Technology to study Diseases Associated with Papillomavirus
• Grantee: Luisa Lina Villa
• Support Opportunities: Research Projects - Thematic Grants