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Young AP, Olorunfemi M, Morrison L, Kelley SA, Laurie A, McEvoy A, Schneiderhan J, Prussack J, O'Dwyer MC, Rockwell P, Zazove P, Gabison J, Chargot J, Gallagher K, Sen A, Chen D, Haro EA, Butcher EA, Alves ML, El Khoury C, Dendrinos ML, Brashear N, Smith R, Lieberman RW, Saunders N, Campbell E, Walline HM, Harper DM. Cervical cancer screening: Impact of collection technique on human papillomavirus detection and genotyping. Prev Med Rep 2025; 50:102971. [PMID: 39906308 PMCID: PMC11791345 DOI: 10.1016/j.pmedr.2025.102971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2024] [Revised: 01/09/2025] [Accepted: 01/10/2025] [Indexed: 02/06/2025] Open
Abstract
Background The Food and Drug Administration (FDA) in the US approved primary human papillomavirus (HPV) testing for speculum-based cervical cancer screening ten years ago and, in May 2024, approved the self-collection technique. Our study defines the kappa agreement between self- and speculum-based collection techniques for 15 types of high-risk HPV. Additionally, we describe the sensitivity and specificity ratios for HPV testing using both collection methods. Methods Participants recruited in 2020-2022 included 97 colposcopy attendees and 96 routine primary care screening attendees aged 30-65, who agreed to self-sample before their clinically scheduled speculum-based exam. Prevalence-based kappa calculated agreement, sensitivity and specificity ratios calculated accuracy using the cervical intraepithelial neoplasia grade 2 or worse (CIN 2+) threshold. Results The average ages were 45.9 (SD 10.5) and 46.2 (SD 11.0) years for the colposcopy and primary care attendees, respectively. HPV 16, 68, and 39 were the most common types detected. The lower bound of the 95 % Cl for kappa calculations was above 0.81, indicating almost perfect agreement across all HPV genotypes. The sensitivity and specificity ratios were consistent at 1.0 across both collection methods. The HPV positivity rate was significantly higher among colposcopy attendees at 66 % (64/97), compared to 14 % (13/96) among routine primary care screeners. The study identified 17 women with CIN2 + . Conclusions Primary HPV screening with self-collection is equivalent to speculum-based collection among people aged 30-65. The findings emphasize the utility of self-collection in identifying high-grade lesions and the consistency of HPV detection across different collection methods.
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Affiliation(s)
- Alisa P. Young
- Department of Family Medicine, University of Michigan Medical School, 300 North Ingalls Street, NI4C06, Ann Arbor, MI 48109, USA
| | - Mutiya Olorunfemi
- Department of Family Medicine, University of Michigan Medical School, 300 North Ingalls Street, NI4C06, Ann Arbor, MI 48109, USA
| | - Leigh Morrison
- Department of Family Medicine, University of Michigan Medical School, 300 North Ingalls Street, NI4C06, Ann Arbor, MI 48109, USA
| | - Scott A. Kelley
- Department of Family Medicine, University of Michigan Medical School, 300 North Ingalls Street, NI4C06, Ann Arbor, MI 48109, USA
| | - Anna Laurie
- Department of Family Medicine, University of Michigan Medical School, 300 North Ingalls Street, NI4C06, Ann Arbor, MI 48109, USA
| | - Anna McEvoy
- Department of Family Medicine, University of Michigan Medical School, 300 North Ingalls Street, NI4C06, Ann Arbor, MI 48109, USA
| | - Jill Schneiderhan
- Department of Family Medicine, University of Michigan Medical School, 300 North Ingalls Street, NI4C06, Ann Arbor, MI 48109, USA
| | - Julie Prussack
- Department of Family Medicine, University of Michigan Medical School, 300 North Ingalls Street, NI4C06, Ann Arbor, MI 48109, USA
| | - Marie Claire O'Dwyer
- Department of Family Medicine, University of Michigan Medical School, 300 North Ingalls Street, NI4C06, Ann Arbor, MI 48109, USA
| | - Pamela Rockwell
- Department of Family Medicine, University of Michigan Medical School, 300 North Ingalls Street, NI4C06, Ann Arbor, MI 48109, USA
| | - Philip Zazove
- Department of Family Medicine, University of Michigan Medical School, 300 North Ingalls Street, NI4C06, Ann Arbor, MI 48109, USA
| | - Jonathan Gabison
- Department of Family Medicine, University of Michigan Medical School, 300 North Ingalls Street, NI4C06, Ann Arbor, MI 48109, USA
| | - Jane Chargot
- Department of Family Medicine, University of Michigan Medical School, 300 North Ingalls Street, NI4C06, Ann Arbor, MI 48109, USA
| | - Kristina Gallagher
- Department of Family Medicine, University of Michigan Medical School, 300 North Ingalls Street, NI4C06, Ann Arbor, MI 48109, USA
| | - Ananda Sen
- Department of Family Medicine, University of Michigan Medical School, 300 North Ingalls Street, NI4C06, Ann Arbor, MI 48109, USA
- Department of Biostatistics, School of Public Health, 1415 Washington Heights, University of Michigan, Ann Arbor, MI 48109, USA
| | - Dongru Chen
- Department of Family Medicine, University of Michigan Medical School, 300 North Ingalls Street, NI4C06, Ann Arbor, MI 48109, USA
| | - Elizabeth A. Haro
- Department of Family Medicine, University of Michigan Medical School, 300 North Ingalls Street, NI4C06, Ann Arbor, MI 48109, USA
| | - Emma A. Butcher
- Department of Family Medicine, University of Michigan Medical School, 300 North Ingalls Street, NI4C06, Ann Arbor, MI 48109, USA
| | - Martha L. Alves
- Department of Family Medicine, University of Michigan Medical School, 300 North Ingalls Street, NI4C06, Ann Arbor, MI 48109, USA
| | - Christelle El Khoury
- Department of Family Medicine, University of Michigan Medical School, 300 North Ingalls Street, NI4C06, Ann Arbor, MI 48109, USA
| | - Melinda L. Dendrinos
- Department of Obstetrics and Gynecology, 1500 E Medical Center Dr # 9, University of Michigan Medical School, Ann Arbor, MI 48109, USA
| | - Nicole Brashear
- Department of Obstetrics and Gynecology, 1500 E Medical Center Dr # 9, University of Michigan Medical School, Ann Arbor, MI 48109, USA
| | - Roger Smith
- Department of Obstetrics and Gynecology, 1500 E Medical Center Dr # 9, University of Michigan Medical School, Ann Arbor, MI 48109, USA
| | - Richard W. Lieberman
- Department of Obstetrics and Gynecology, 1500 E Medical Center Dr # 9, University of Michigan Medical School, Ann Arbor, MI 48109, USA
| | - Natalie Saunders
- Department of Obstetrics and Gynecology, 1500 E Medical Center Dr # 9, University of Michigan Medical School, Ann Arbor, MI 48109, USA
| | - Elizabeth Campbell
- Department of Obstetrics and Gynecology, 1500 E Medical Center Dr # 9, University of Michigan Medical School, Ann Arbor, MI 48109, USA
| | - Heather M. Walline
- Department of Otolaryngology, 1500 E Medical Center Dr # 1 University of Michigan Medical School, Ann Arbor, MI 48109, USA
| | - Diane M. Harper
- Department of Family Medicine, University of Michigan Medical School, 300 North Ingalls Street, NI4C06, Ann Arbor, MI 48109, USA
- Department of Obstetrics and Gynecology, 1500 E Medical Center Dr # 9, University of Michigan Medical School, Ann Arbor, MI 48109, USA
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Ye D, Duan X, Guan B, Yuan J, Zhu Y, Shi J, Lu Q, Xu G. Biomarker cystatin B expression correlates with pathogenesis in cervical cancer. J Int Med Res 2024; 52:3000605241233959. [PMID: 38436260 PMCID: PMC10913530 DOI: 10.1177/03000605241233959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 01/29/2024] [Indexed: 03/05/2024] Open
Abstract
OBJECTIVE Cervical cancer (CC) is one of the most common gynecologic malignancies worldwide. Although rapid improvements have been made regarding its prevention and treatment, little is known about disease pathogenesis and the clinical relevance of reliable biomarkers. The present study evaluated the expression of cystatin B (CSTB) as a potential biomarker of CC. METHODS Tissue microarray analysis and immunohistochemical staining were performed to detect CSTB expression, while CSTB mRNA and protein expression levels of freshly isolated CC tissue were measured by quantitative real-time PCR and western blot, respectively. Bioinformatics were used to analyze the CSTB co-expression network and functional enrichments. RESULTS We observed high CSTB mRNA and protein expression levels in CC tissues, which was confirmed by tissue microarray in a comparison with paired adjacent non-cancerous cervical tissue samples. CSTB gene enrichments and associations with co-expressed genes were also observed. Further analysis showed that elevated CSTB expression was associated with pathological progress in CC. CONCLUSION Our data demonstrate that CSTB has the potential to be used as a tissue biomarker with clinical value in patients with CC, which may aid the development of intervention strategies.
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Affiliation(s)
- Danjuan Ye
- Department of Obstetrics and Gynaecology, Jinshan Hospital, Fudan University, Shanghai, P. R. China
| | - Xiaoling Duan
- Department of Obstetrics and Gynaecology, Jinshan Hospital, Fudan University, Shanghai, P. R. China
| | - Bin Guan
- Research Center for Clinical Medicine, Jinshan Hospital, Fudan University, Shanghai, P. R. China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, P. R. China
| | - Jia Yuan
- Research Center for Clinical Medicine, Jinshan Hospital, Fudan University, Shanghai, P. R. China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, P. R. China
| | - Yan Zhu
- Research Center for Clinical Medicine, Jinshan Hospital, Fudan University, Shanghai, P. R. China
| | - Jimin Shi
- Research Center for Clinical Medicine, Jinshan Hospital, Fudan University, Shanghai, P. R. China
| | - Qi Lu
- Department of Obstetrics and Gynaecology, Jinshan Hospital, Fudan University, Shanghai, P. R. China
- Research Center for Clinical Medicine, Jinshan Hospital, Fudan University, Shanghai, P. R. China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, P. R. China
| | - Guoxiong Xu
- Research Center for Clinical Medicine, Jinshan Hospital, Fudan University, Shanghai, P. R. China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, P. R. China
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