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Cleveland AA, Gargano JW, Park IU, Griffin MR, Niccolai LM, Powell M, Bennett NM, Saadeh K, Pemmaraju M, Higgins K, Ehlers S, Scahill M, Jones MLJ, Querec T, Markowitz LE, Unger ER. Cervical adenocarcinoma in situ: Human papillomavirus types and incidence trends in five states, 2008-2015. Int J Cancer 2020; 146:810-818. [PMID: 30980692 PMCID: PMC9112013 DOI: 10.1002/ijc.32340] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 03/19/2019] [Accepted: 04/01/2019] [Indexed: 08/05/2023]
Abstract
Primary prevention through the use of human papillomavirus (HPV) vaccination is expected to impact both cervical intraepithelial neoplasia (CIN) and adenocarcinoma in situ (AIS). While CIN is well described, less is known about the epidemiology of AIS, a rare cervical precancer. We identified AIS and CIN grade 3 (CIN3) cases through population-based surveillance, and analyzed data on HPV types and incidence trends overall, and among women screened for cervical cancer. From 2008 to 2015, 470 AIS and 6,587 CIN3 cases were identified. The median age of women with AIS was older than those with CIN3 (35 vs. 31 years; p < 0.01). HPV16 was the most frequently detected type in both AIS and CIN3 (57% in AIS; 58% in CIN3), whereas HPV18 was the second most common type in AIS and less common in CIN3 (38% vs. 5%; p < 0.01). AIS lesions were more likely than CIN3 lesions to be positive for high-risk types targeted by the bivalent and quadrivalent vaccines (HPV16/18, 92% vs. 63%; p < 0.01), and 9-valent vaccine (HPV16/18/31/33/45/52/58, 95% vs. 87%; p < 0.01). AIS incidence rates decreased significantly in the 21-24 year age group (annual percent change [APC] overall: -22.1%, 95% CI: -33.9 to -8.2; APC among screened: -16.1%, 95% CI: -28.8 to -1.2), but did not decrease significantly in any older age group. This report on the largest number of genotyped AIS cases to date suggests an important opportunity for vaccine prevention of AIS, and is the first to document a decline in AIS incidence rates among young women during the vaccine era.
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Affiliation(s)
| | | | - Ina U. Park
- Department of Family and Community Medicine, School of Medicine, University of California San Francisco, San Francisco, CA, USA
| | | | | | | | - Nancy M. Bennett
- University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
| | - Kayla Saadeh
- California Emerging Infections Program, Oakland, CA, USA
| | | | - Kyle Higgins
- Yale School of Public Health, New Haven, CT, USA
| | - Sara Ehlers
- Oregon Department of Human Services, Portland, OR, USA
| | - Mary Scahill
- University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
| | | | - Troy Querec
- Centers for Disease Control and Prevention, Atlanta, GA, USA
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Affiliation(s)
- Maurie Markman
- Cancer Treatment Centers of America, Philadelphia, PA 19124, USA
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Matsumoto K, Yaegashi N, Iwata T, Yamamoto K, Aoki Y, Okadome M, Ushijima K, Kamiura S, Takehara K, Horie K, Tasaka N, Sonoda K, Takei Y, Aoki Y, Konnai K, Katabuchi H, Nakamura K, Ishikawa M, Watari H, Yoshida H, Matsumura N, Nakai H, Shigeta S, Takahashi F, Noda K, Yoshikawa H. Reduction in HPV16/18 prevalence among young women with high-grade cervical lesions following the Japanese HPV vaccination program. Cancer Sci 2019; 110:3811-3820. [PMID: 31596999 PMCID: PMC6890435 DOI: 10.1111/cas.14212] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Revised: 10/04/2019] [Accepted: 10/06/2019] [Indexed: 12/25/2022] Open
Abstract
The Japanese government began a human papillomavirus (HPV) vaccination program for girls aged 12‐16 years in 2010 but withdrew its recommendation in 2013 because of potential adverse effects, leading to drastically reduced vaccination uptake. To evaluate population‐level effects of HPV vaccination, women younger than 40 years of age newly diagnosed with cervical intraepithelial neoplasia grade 1‐3 (CIN1‐3), adenocarcinoma in situ (AIS), or invasive cervical cancer (ICC) have been registered at 21 participating institutes each year since 2012. A total of 7709 women were registered during 2012‐2017, of which 5045 were HPV genotyped. Declining trends in prevalence of vaccine types HPV16 and HPV18 during a 6‐year period were observed in CIN1 (50.0% to 0.0%, Ptrend < .0001) and CIN2‐3/AIS (83.3% to 45.0%, Ptrend = .07) only among women younger than 25 years of age. Overall, HPV vaccination reduced the proportion of HPV16/18‐attributable CIN2‐3/AIS from 47.7% to 33.0% (P = .003): from 43.5% to 12.5% as routine vaccination (P = .08) and from 47.8% to 36.7% as catch‐up vaccination (P = .04). The HPV16/18 prevalence in CIN2‐3/AIS cases was significantly reduced among female individuals who received their first vaccination at age 20 years or younger (P = .02). We could not evaluate vaccination effects on ICC owing to low incidence of ICC among women aged less than 25 years. We found HPV vaccination to be effective in protecting against HPV16/18‐positive CIN/AIS in Japan; however, our data did not support catch‐up vaccination for women older than 20 years. Older adolescents who skipped routine vaccination due to the government’s suspension of its vaccine recommendation could benefit from receiving catch‐up vaccination before age 20 years.
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Affiliation(s)
- Koji Matsumoto
- Department of Obstetrics and Gynecology, Showa University School of Medicine, Tokyo, Japan
| | - Nobuo Yaegashi
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Takashi Iwata
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan
| | | | - Yoichi Aoki
- Department of Gynecology, Cancer Institute Hospital, Tokyo, Japan
| | - Masao Okadome
- Gynecology Service, NHO Kyushu Cancer Center, Fukuoka, Japan
| | - Kimio Ushijima
- Department of Obstetrics and Gynecology, Kurume University School of Medicine, Kurume, Japan
| | - Shoji Kamiura
- Department of Gynecology, Osaka International Cancer Institute, Osaka, Japan
| | - Kazuhiro Takehara
- Department of Gynecologic Oncology, National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan
| | - Koji Horie
- Department of Gynecology, Saitama Cancer Center, Saitama, Japan
| | - Nobutaka Tasaka
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Kenzo Sonoda
- Department of Gynecology and Obstetrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yuji Takei
- Department of Obstetrics and Gynecology, Jichi Medical University, Tochigi, Japan
| | - Yoichi Aoki
- Department of Obstetrics and Gynecology, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Katsuyuki Konnai
- Department of Gynecology, Kanagawa Cancer Center, Kanagawa, Japan
| | - Hidetaka Katabuchi
- Department of Obstetrics and Gynecology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Keiichiro Nakamura
- Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Mitsuya Ishikawa
- Department of Gynecology, National Cancer Center Hospital, Tokyo, Japan
| | - Hidemichi Watari
- Department of Obstetrics and Gynecology, Hokkaido University, Graduate School of Medicine and Faculty of Medicine, Sapporo, Japan
| | - Hiroyuki Yoshida
- Department of Gynecologic Oncology, Saitama Medical University International Medical Center, Saitama, Japan
| | - Noriomi Matsumura
- Department of Gynecology and Obstetrics, Kyoto University Graduate School of Medicine, Kyoto, Japan.,Department of Obstetrics and Gynecology, Kindai University, Faculty of Medicine, Osaka, Japan
| | - Hidekatsu Nakai
- Department of Obstetrics and Gynecology, Kindai University, Faculty of Medicine, Osaka, Japan
| | - Shogo Shigeta
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Fumiaki Takahashi
- Division of Medical Engineering, Department of Information Science, Iwate Medical University, Morioka, Japan
| | | | - Hiroyuki Yoshikawa
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
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Knowledge, Attitudes, and Practices towards Cervical Cancer and Screening amongst Female Healthcare Professionals: A Cross-Sectional Study. JOURNAL OF ONCOLOGY 2019; 2019:5423130. [PMID: 31772579 PMCID: PMC6854973 DOI: 10.1155/2019/5423130] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Revised: 07/13/2019] [Accepted: 08/28/2019] [Indexed: 12/24/2022]
Abstract
Background Cervical cancer is a potentially preventable disease if appropriate screening and prophylactic strategies are employed. However, lack of knowledge and awareness can result in underutilization of the preventive strategies. Healthcare professionals with adequate knowledge play a huge role in influencing the beliefs and practices of the general public in a positive way. We assessed the knowledge, attitudes, and practices of cervical cancer and screening amongst female healthcare professionals at King Fahad Medical City (KFMC), Saudi Arabia. Methods We conducted a cross-sectional study on female healthcare professionals at KFMC. Data were collected using a predesigned, tested, and self-administered questionnaire. The questionnaire included specific sections to test the participants' knowledge, attitude, and practices related to cervical cancer and its screening. Data analysis was done using descriptive statistics. Results Data from 395 participants were included in the final analysis. The majority of the study participants were nurses (n = 261, 66.1%). The mean age of the participants was 34.7 years and 239 (60.5%) participants were married. Only 16 (4.0%) participants appeared to have good level knowledge of cervical cancer (in terms of risk factors, vulnerability, signs and symptoms, ways of prevention, and ways of screening) and 58 (14.7%) participants had fair level knowledge. A total of 343 (86.8%) participants believed that Pap smear test is a useful test for the detection of cervical cancer and 103 (26.2%) participants had undergone Pap smear testing. Conclusions Our study population showed poor knowledge of cervical cancer as a disease. The participants had a fair knowledge of Pap smear testing, but only a quarter of the cohort had undergone testing themselves. This study highlights the need for formal educational programs for the healthcare workers at KFMC specifically to improve their knowledge regarding the risk factors and early signs and symptoms of cervical cancer.
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Saadeh K, Park I, Gargano JW, Whitney E, Querec TD, Hurley L, Silverberg M. Prevalence of human papillomavirus (HPV)-vaccine types by race/ethnicity and sociodemographic factors in women with high-grade cervical intraepithelial neoplasia (CIN2/3/AIS), Alameda County, California, United States. Vaccine 2019; 38:39-45. [PMID: 31611099 DOI: 10.1016/j.vaccine.2019.09.103] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 09/26/2019] [Accepted: 09/30/2019] [Indexed: 12/13/2022]
Abstract
We evaluated racial/ethnic differences in prevalence of oncogenic HPV types targeted by the quadrivalent HPV vaccine (16/18) and nonavalent HPV vaccine (31/33/45/52/58) in women diagnosed with CIN2/3/AIS after quadrivalent HPV vaccine introduction (2008-2015). Typing data from 1810 cervical tissue specimen from HPV-IMPACT (Alameda County, California, US), a population-based CIN2/3/AIS surveillance effort, were analyzed. Using log-binomial regression, we calculated adjusted prevalence ratios (aPR) and 95% confidence intervals (CI) comparing type prevalence by race/ethnicity, adjusted for health insurance, age, CIN2/3/AIS grade, and time period, overall and in the "early vaccine era" (2008-2011) and "later vaccine era" (2012-2015). Overall, oncogenic HPV16/18 prevalence was significantly lower among black (43%) and Hispanic (43%) women compared with white (52%) women (aPR (95% CI): 0.80 (0.70, 0.93) and 0.80 (0.70, 0.91), respectively). In 2008-2011, proportion of HPV16/18 detected was significantly lower in black (47%), Hispanic (46%), and Asian (42%) women compared to white (58%) women (aPR (95% CI): 0.80 (0.67, 0.96), 0.75 (0.63, 0.90), and 0.73 (0.58, 0.90), respectively). There were no significant differences in 2012-2015. Between the two eras, HPV16/18 prevalence declined in white (-11%), black (-9%), and Hispanic (-6%) women, and increased in Asian women (12%). Decreasing HPV 16/18 prevalence in CIN2/3/AIS lesions in white, black, and Hispanic women may suggest benefit from quadrivalent vaccination. In our unadjusted analysis of HPV31/33/45/52/58, prevalence did not differ significantly by race/ethnicity, but was significantly higher among Hispanic women (32%) compared to white women (27%) after adjustment (aPR (95%CI): 1.22 (1.02, 1.47). Prevalence was also non-significantly higher among black (32%) and Asian (33%) women. This analysis suggests that the nonavalent vaccine's potential for impact against cervical precancers will not be lower in women of color compared to white women. These data underscore the importance of equitable vaccination in facilitating continued declines of vaccine-preventable HPV types among all women.
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Affiliation(s)
- Kayla Saadeh
- Sexually Transmitted Diseases Control Branch (STDCB), Division of Communicable Disease Control (DCDC), Center for Infectious Diseases (CID), California Department of Public Health (CDPH), Richmond, CA, United States; California Emerging Infections Program (CEIP), Oakland, CA, United States.
| | - Ina Park
- Department of Family and Community Medicine, University of California San Francisco School of Medicine, San Francisco, CA, United States
| | - Julia W Gargano
- Viral Vaccine Preventable Diseases Branch, Division of Viral Diseases (DVD), National Center for Immunization and Respiratory Diseases (NCIRD), Centers for Disease Control and Prevention (CDC), Atlanta, GA, United States
| | - Erin Whitney
- Sexually Transmitted Diseases Control Branch (STDCB), Division of Communicable Disease Control (DCDC), Center for Infectious Diseases (CID), California Department of Public Health (CDPH), Richmond, CA, United States; California Emerging Infections Program (CEIP), Oakland, CA, United States
| | - Troy D Querec
- Chronic Viral Diseases Branch, Division of High-Consequence Pathogens and Pathology (DHCPP), CDC, Atlanta, GA, United States
| | - Leo Hurley
- Division of Research, Kaiser Permanente Northern California (KPNC), Oakland, CA, United States
| | - Michael Silverberg
- Division of Research, Kaiser Permanente Northern California (KPNC), Oakland, CA, United States
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Kempe A, O'Leary ST, Markowitz LE, Crane LA, Hurley LP, Brtnikova M, Beaty BL, Meites E, Stokley S, Lindley MC. HPV Vaccine Delivery Practices by Primary Care Physicians. Pediatrics 2019; 144:e20191475. [PMID: 31527175 PMCID: PMC8297056 DOI: 10.1542/peds.2019-1475] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/24/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND AND OBJECTIVES To examine, among pediatricians and family physicians (FPs) (1) human papillomavirus (HPV) vaccine delivery practices, (2) delivery experiences, and (3) attitudes regarding new 2-dose HPV vaccination schedules. METHODS We surveyed nationally representative networks of pediatricians and FPs by Internet or mail from July 2018 to September 2018. Multivariable regression was used to assess factors associated with refusal or deferral rates of ≥50% among 11- to 12-year-old patients. RESULTS The response rate was 65% (302 pediatricians and 228 FPs included). Pediatricians who strongly recommended the HPV vaccine ranged from 99% for patients ≥15 years old (female) to 83% for those 11 to 12 years old (male); FPs ranged from 90% for patients ≥15 years old (female) to 66% for those 11 to 12 years old (male) (P < .0001 between specialties). Sixty-five percent of pediatricians and 42% of FPs always or almost always used presumptive style when discussing the HPV vaccine (P < .0001). Overall, 40% used standing orders and 42% had electronic alerts. Among pediatricians, the proportion reporting a refusal or deferral rate ≥50% was 19% for female patients and 23% for male patients 11 to 12 years old; FPs reported 27% and 36%, respectively. In the multivariable regression (both sexes), refusal or deferral was associated with physicians not strongly recommending the HPV vaccine to 11- to 12-year-old patients, not using a presumptive style, perceiving less resistance when introducing the HPV vaccine to a 13-year-old patient versus an 11- or 12-year-old patient, and anticipating an uncomfortable conversation when recommending the HPV vaccine to an 11- or 12-year-old patient. Eighty-nine percent of pediatricians and 79% of FPs reported that more adolescents <15 years old are completing the HPV series now that only 2 doses are recommended. CONCLUSIONS Although most physicians strongly recommend the HPV vaccine to 11- to 12-year-old patients, our data reveal areas for improvement in recommendation and delivery methods. Most physicians perceive that the 2-dose schedule is resulting in higher HPV completion rates.
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Affiliation(s)
- Allison Kempe
- Adult and Child Consortium for Health Outcomes Research and Delivery Science, School of Medicine, University of Colorado and Children's Hospital Colorado, Aurora, Colorado;
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Sean T O'Leary
- Adult and Child Consortium for Health Outcomes Research and Delivery Science, School of Medicine, University of Colorado and Children's Hospital Colorado, Aurora, Colorado
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Lauri E Markowitz
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Lori A Crane
- Adult and Child Consortium for Health Outcomes Research and Delivery Science, School of Medicine, University of Colorado and Children's Hospital Colorado, Aurora, Colorado
- Department of Community and Behavioral Health, Colorado School of Public Health, University of Colorado, Aurora, Colorado; and
| | - Laura P Hurley
- Adult and Child Consortium for Health Outcomes Research and Delivery Science, School of Medicine, University of Colorado and Children's Hospital Colorado, Aurora, Colorado
- Division of General Internal Medicine, Denver Health, Denver, Colorado
| | - Michaela Brtnikova
- Adult and Child Consortium for Health Outcomes Research and Delivery Science, School of Medicine, University of Colorado and Children's Hospital Colorado, Aurora, Colorado
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Brenda L Beaty
- Adult and Child Consortium for Health Outcomes Research and Delivery Science, School of Medicine, University of Colorado and Children's Hospital Colorado, Aurora, Colorado
| | - Elissa Meites
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Shannon Stokley
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Megan C Lindley
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
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Printz C. HPV infections most often linked to cervical cancer have declined. Cancer 2019; 125:2336-2337. [DOI: 10.1002/cncr.32349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Anal cancer risk: HPV-based cervical screening programmes. THE LANCET. INFECTIOUS DISEASES 2019; 19:799-800. [PMID: 31204305 DOI: 10.1016/s1473-3099(19)30296-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Accepted: 04/12/2019] [Indexed: 01/04/2023]
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McClung NM, Gargano JW, Park IU, Whitney E, Abdullah N, Ehlers S, Bennett NM, Scahill M, Niccolai LM, Brackney M, Griffin MR, Pemmaraju M, Querec TD, Cleveland AA, Unger ER, Markowitz LE. Estimated Number of Cases of High-Grade Cervical Lesions Diagnosed Among Women - United States, 2008 and 2016. MMWR-MORBIDITY AND MORTALITY WEEKLY REPORT 2019; 68:337-343. [PMID: 30998672 PMCID: PMC6476057 DOI: 10.15585/mmwr.mm6815a1] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Hsieh MC, Van Dyne E, Lefante C, Shapiro JA, Pordell P, Lynch MA, Gomez N, Mumphrey B, Maniscalco L, Jetly-Shridhar R, Saraiya M, Wu XC. Evaluating the Use of LAST 2-Tiered Nomenclature and Its Impact on Reporting Cervical Lesions in a Population-Based Cancer Registry. JOURNAL OF REGISTRY MANAGEMENT 2019; 46:120-127. [PMID: 32822336 PMCID: PMC7933986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
BACKGROUND Since 2012, the Lower Anogenital Squamous Terminology (LAST) Project recommended a 2-tiered nomenclature, low-grade and high-grade squamous intraepithelial lesion (LSIL and HSIL), to replace the 3-tiered cervical intraepithelial neoplasia (CIN) system for HPV-associated lesions. Prior to 2019, preinvasive cervical lesions classified as CIN3, severe dysplasia, carcinoma in situ (CIS), and adenocarcinoma in situ (AIS) were considered reportable to the Louisiana Tumor Registry for a CIN3 project funded by the Centers for Disease Control and Prevention (CDC); but lesions classified exclusively as high-grade/HSIL based on the 2-tiered system were not considered reportable. Due to the terminology changes, we wanted to know whether pre-2019 reportable criteria need to be modified to capture all reportable precancerous cervical cases diagnosed in 2019 forward. OBJECTIVES To evaluate the utilization of LAST 2-tiered classification, low-grade and high-grade squamous intraepithelial lesion, and p16 immunohistochemistry (IHC) testing on cervical biopsy/surgical specimens, assess the search criteria needed to identify high-grade lesions for the CDC-funded CIN3 project, and assess the impact of underreporting cervical lesions caused by terminology changes. METHODS An equal number of abnormal/precancerous and normal cervical findings from biopsy pathology reports received in 2015 were randomly selected by an artificial intelligence (AI) search engine developed by Artificial Intelligence in Medicine Inc (AIM) using pre2019 search criteria. Selected pathology reports were reflagged for the reportability by AIM audit software based on 2019 search criteria and manually reviewed for the use of reportable terms including CIN3, severe dysplasia, CIS, AIS, highgrade/HSIL terminology, and CIN2 or CIN2-3 with positive p16 IHC testing. Cohen's kappa statistic was used to assess the agreement between AIM auto-coding and manual review. Positive predictive values (PPV) and sensitivity tests were computed to evaluate the reportable terms. RESULTS Six out of 9 surveyed laboratories used 2-tiered terminology on cervical biopsy pathology reports and 7 performed p16 IHC tests. Of 1,974 randomly selected reports from 5 laboratories, 987 were flagged as precancer by AI using pre-2019 search criteria. After adding the high-grade/HSIL term into pre-2019 search criteria, precancerous reports increased by 29%. After manual review, 41.6% of these cases were reportable precancerous cervical cases with a PPV of 0.65 (95% CI, 0.62-0.67) and 13.6% had p16 IHC performed. CONCLUSIONS Both the 2-tiered and 3-tiered nomenclature are needed to ensure complete identification of all reportable high-grade cervical lesions.
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Affiliation(s)
- Mei-Chin Hsieh
- School of Public Health, Louisiana State University Health Sciences Center, New Orleans, Louisiana
| | | | - Christina Lefante
- School of Public Health, Louisiana State University Health Sciences Center, New Orleans, Louisiana
| | - Jean A. Shapiro
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Paran Pordell
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Mary Anne Lynch
- School of Public Health, Louisiana State University Health Sciences Center, New Orleans, Louisiana
| | - Natalie Gomez
- School of Public Health, Louisiana State University Health Sciences Center, New Orleans, Louisiana
| | - Brent Mumphrey
- School of Public Health, Louisiana State University Health Sciences Center, New Orleans, Louisiana
| | - Lauren Maniscalco
- School of Public Health, Louisiana State University Health Sciences Center, New Orleans, Louisiana
| | - Rachna Jetly-Shridhar
- School of Medicine, Louisiana State University Health Sciences Center, New Orleans, Louisiana
| | - Mona Saraiya
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Xiao-Cheng Wu
- School of Public Health, Louisiana State University Health Sciences Center, New Orleans, Louisiana
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Šterbenc A, Triglav T, Poljak M. An update on prophylactic human papillomavirus (HPV) vaccines: a review of key literature published between September 2018 and September 2019. ACTA DERMATOVENEROLOGICA ALPINA PANNONICA ET ADRIATICA 2019. [DOI: 10.15570/actaapa.2019.38] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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