13-Type HPV DNA Test versus 5-Type HPV mRNA Test in Triage of Women Aged 25–33 Years with Minor Cytological Abnormalities–6 Years of Follow-Up

Amir Rad (), Sveinung Wergeland Sørbye, Tormod Brenn, Sweta Tiwari, Maja-Lisa Løchen and Finn Egil Skjeldestad
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Amir Rad: Department of Community Medicine & Department of Clinical Medicine, UiT The Arctic University of Norway, 9037 Tromsø, Norway
Sveinung Wergeland Sørbye: Department of Pathology, University Hospital of North Norway, 9019 Tromsø, Norway
Tormod Brenn: Department of Community Medicine, UiT The Arctic University of Norway, 9037 Tromsø, Norway
Sweta Tiwari: Department of Community Medicine, UiT The Arctic University of Norway, 9037 Tromsø, Norway
Maja-Lisa Løchen: Department of Community Medicine & Department of Clinical Medicine, UiT The Arctic University of Norway, 9037 Tromsø, Norway
Finn Egil Skjeldestad: Department of Community Medicine, UiT The Arctic University of Norway, 9037 Tromsø, Norway

IJERPH, 2023, vol. 20, issue 5, 1-12

Abstract: Background: A specific, cost-effective triage test for minor cytological abnormalities is essential for cervical cancer screening among younger women to reduce overmanagement and unnecessary healthcare utilization. We compared the triage performance of one 13-type human papillomavirus (HPV) DNA test and one 5-type HPV mRNA test. Methods: We included 4115 women aged 25–33 years with a screening result of atypical squamous cells of undetermined significance (ASC-US) or low-grade squamous intraepithelial lesions (LSIL) recorded in the Norwegian Cancer Registry during 2005–2010. According to Norwegian guidelines, these women went to triage (HPV testing and repeat cytology: 2556 were tested with the Hybrid Capture 2 HPV DNA test, which detects the HPV types 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, and 68; and 1559 were tested with the PreTect HPV-Proofer HPV mRNA test, which detects HPV types 16, 18, 31, 33, and 45). Women were followed through December 2013. Results: HPV positivity rates at triage were 52.8% and 23.3% among DNA- and mRNA-tested women ( p < 0.001), respectively. Referral rates for colposcopy and biopsy and repeat testing (HPV + cytology) after triage were significantly higher among DNA-tested (24.9% and 27.9%) compared to mRNA-tested women (18.3% and 5.1%), as were cervical intraepithelial neoplasia grade 3 or worse (CIN3+) detection rates (13.1% vs. 8.3%; p < 0.001). Ten cancer cases were diagnosed during follow-up; eight were in DNA-tested women. Conclusion: We observed significantly higher referral rates and CIN3+ detection rates in young women with ASC-US/LSIL when the HPV DNA test was used at triage. The mRNA test was as functional in cancer prevention, with considerably less healthcare utilization.

Keywords: cervical cancer screening; triage; HPV DNA test; HPV mRNA test; CIN3+ (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
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