D Clayton

E Lynge

G Ronco

HC Kitchener

J Cuzick

K Elfgren

L Kotaniemi-Talonen

M Leinonen

M Rebolj

MH Mayrand

NW Bulkmans

P Naucler

P Sasieni

R Sankaranarayanan

English

PubMed

BACKGROUND: It has been suggested that adjustment for incomplete compliance with follow-up in women with positive human papillomavirus (HPV) tests would be appropriate for estimating the true sensitivity of cervical screening with HPV testing. We assessed the compliance and its impact on &gt; or =CIN3 detection in all eight randomised controlled trials (RCT) with published baseline-round data.METHODS: We extracted data on recommended follow-up procedures, follow-up compliance, and &gt; or =CIN3 detection for both arms of each RCT, and assessed their correlation.RESULTS: Compliance with a direct referral for colposcopy was around 90% in all RCTs, whereas compliance with repeated testing among HPV-positive/cytology-negative women was around 60% in three RCTs and 73% in one RCT. Detection of &gt; or =CIN3 was significantly increased in two out of six RCTs with reported data. The correlation between compliance with follow-up in HPV-positive women and relative &gt; or =CIN3 detection was 0.48 (P=0.33).CONCLUSION: There is at present scant evidence to support the view that the measured sensitivity of HPV screening is a simple reflection of compliance with follow-up. Adjustment of measured cervical intraepithelial neoplasia detection on the basis of compliance data may not always be justifiable, and if adjustment is made, it should be used very judiciously.</p

Rebolj, M

Lynge, E

King's Research Portal

Incomplete follow-up of positive HPV tests:overview of randomised controlled trials on primary cervical screening

Crossref

British Journal of Cancer

Incomplete follow-up of positive HPV tests: overview of randomised controlled trials on primary cervical screening

Copenhagen University Research Information System

Assess 13: 1–150, iii–iv

Cancer Inst 100: 492–501

Human papillomavirus DNA testing for the detection of cervical intraepithelial neoplasia grade 3 and cancer: 5-year follow-up of a randomised controlled implementation trial.

Lancet Oncol 10: 841–842 The NHS Information Centre, Workforce and Facilities Team

Obstet Gynecol 193: 650–657 IARC (2005) Cervix Cancer Screening.

Statistical Models in Epidemiology. Oxford University Press: Oxford Cuzick

http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2920025

Incomplete follow-up of positive HPV tests: overview of randomised controlled trials on primary cervical screening

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King's Research Portal

Crossref

Copenhagen University Research Information System