Gage JC, Raine-Bennett T, Schiffman M, Clarke MA, Cheung LC, Poitras NE, Varnado NE, Katki HA, Castle PE, Befano B, Chandra M, Rydzak G, Lorey T, Wentzensen N. The Improving Risk Informed HPV Screening (IRIS) Study: Design and Baseline Characteristics.
Cancer Epidemiol Biomarkers Prev 2021;
31:486-492. [PMID:
34789470 DOI:
10.1158/1055-9965.epi-21-0865]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 09/21/2021] [Accepted: 11/09/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND
Cervical cancer screening with high-risk HPV (HrHPV) testing is being introduced. Most HrHPV infections are transient, requiring triage tests to identify individuals at highest risk for progression to cervical cancer. Head-to-head comparisons of available strategies for screening and triage are needed. Endometrial and ovarian cancers could be amenable to similar testing.
METHODS
Between 2016-2021 discard cervical cancer screening specimens from women ages 25-65 undergoing screening at Kaiser Permanente Northern California were collected. Specimens were aliquoted, stabilized, and stored frozen. HPV, cytology and histopathology results as well as demographic and co-factor information were obtained from electronic medical records. Follow-up collection of specimens was conducted for 2 years and EMR-based data collection was planned five years.
RESULTS
Collection of enrollment and follow-up specimens are complet and EMR-based follow-up data collection is ongoing. At baseline, specimens were collected from 54,971 HPV-positive, 10,219 HPV-negative/Pap-positive and 12,751 HPV-negative/Pap-negative women. Clinical history prior to baseline was available for 72.6% of individuals, of which 53.9% were undergoing routine screening, 8.6% recently had an abnormal screen, 30.3% had previous colposcopy, and 7.2% had previous treatment. As of November 2020, 55.6% had one or more colposcopies, yielding 5,515 CIN2, 2,735 CIN3 and 147 cancer histopathology diagnoses.
CONCLUSIONS
This robust population-based cohort study represents all stages of cervical cancer screening, management, and post-treatment follow-up.
IMPACT
The IRIS study is a unique and highly relevant resource allowing for natural history studies and rigorous evaluation of candidate HrHPV screening and triage markers, while permitting studies of biomarkers associated with other gynecological cancers.
Collapse