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White C, Reynolds S, Murphy K, Keegan H, Naik P, O'Brien R, Pilkington L, Sharkey Ochoa I, Glesson G, Russell N, Nuttall D, Tewari P, Wright F, O'Toole S, Sharp L, Flannelly G, O'Leary JJ, Martin CM. Performance of the HPV E6/E7 mRNA Aptima HPV assay combined with partial genotyping compared with the HPV DNA Cobas 4800 HPV test for use in primary screening: Results from the CERVIVA HPV primary screening study in Ireland. Int J Cancer 2024; 154:53-64. [PMID: 37632406 DOI: 10.1002/ijc.34685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 06/06/2023] [Accepted: 06/12/2023] [Indexed: 08/28/2023]
Abstract
There are currently several validated HPV tests. However, longitudinal data which spans appropriate age ranges, as well as evaluation of potential screening algorithms are necessary for screening programmes choice of test. The objective of our study was to evaluate the performance of HPV mRNA and HPV DNA testing, including partial genotyping, in routine cervical screening. As part of the CERVIVA HPV Primary Screening Study, ThinPrep samples from 10 150 women were tested for HPV mRNA using the Aptima HPV assay and HPV DNA using the Cobas 4800 HPV test. HPV mRNA-positive women were further assessed with the Aptima genotyping assay for HPV 16/18/45. Baseline cytology and prospective follow-up data were collected. The performance of the two tests was examined over 42 months (to date). HPV mRNA demonstrated equivalent sensitivity to HPV DNA testing for detection of CIN2+ (93.2% [92.4-93.9] vs 92.8% [92.0-93.6], respectively) and CIN3+ (94.6% [93.8-95.3] vs 94.6% [93.8-95.3]). HPV mRNA testing had significantly higher specificity compared to HPV DNA for detection of CIN2+ (84.0% [83.5-84.5] vs 80.8% [80.2-81.4], respectively) and CIN3+ (88.44% [88.2-88.6] vs 85.62 [85.4-85.9]). The proportion of CIN2+ and CIN3+, over 3 years (42 months), in HPV-negative women was comparable for both RNA (0.20% and 0.10%) and DNA (0.22% and 0.11%). Genotyping data was comparable across both assay platforms. In the context of HPV primary screening HPV mRNA testing has potential to reduce triage tests and follow-up tests at 12 months compared to DNA testing, with no significant difference in detection of CIN2+ and CIN3+.
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Affiliation(s)
- Christine White
- TCD CERVIVA Molecular Pathology Laboratory, Trinity College Dublin, Dublin, Ireland
- Discipline of Histopathology, St. James' University Hospital, Trinity College Dublin, Dublin, Ireland
- The Coombe Hospital, Dublin 8, Ireland
| | - Stephen Reynolds
- TCD CERVIVA Molecular Pathology Laboratory, Trinity College Dublin, Dublin, Ireland
- The Coombe Hospital, Dublin 8, Ireland
| | - Katherine Murphy
- TCD CERVIVA Molecular Pathology Laboratory, Trinity College Dublin, Dublin, Ireland
| | - Helen Keegan
- TCD CERVIVA Molecular Pathology Laboratory, Trinity College Dublin, Dublin, Ireland
- The Coombe Hospital, Dublin 8, Ireland
| | - Padma Naik
- TCD CERVIVA Molecular Pathology Laboratory, Trinity College Dublin, Dublin, Ireland
- Discipline of Histopathology, St. James' University Hospital, Trinity College Dublin, Dublin, Ireland
- The Coombe Hospital, Dublin 8, Ireland
| | | | - Loretto Pilkington
- TCD CERVIVA Molecular Pathology Laboratory, Trinity College Dublin, Dublin, Ireland
| | - Imogen Sharkey Ochoa
- TCD CERVIVA Molecular Pathology Laboratory, Trinity College Dublin, Dublin, Ireland
| | - Grainne Glesson
- CervicalCheck, National Screening Service, Kings Inns House, Dublin 1, Ireland
| | - Noirin Russell
- CervicalCheck, National Screening Service, Kings Inns House, Dublin 1, Ireland
| | - David Nuttall
- TCD CERVIVA Molecular Pathology Laboratory, Trinity College Dublin, Dublin, Ireland
| | - Prerna Tewari
- TCD CERVIVA Molecular Pathology Laboratory, Trinity College Dublin, Dublin, Ireland
- Discipline of Histopathology, St. James' University Hospital, Trinity College Dublin, Dublin, Ireland
- Trinity St James Cancer Institute, Trinity College Dublin, Dublin, Ireland
| | - Fiona Wright
- CervicalCheck, National Screening Service, Kings Inns House, Dublin 1, Ireland
| | - Sharon O'Toole
- TCD CERVIVA Molecular Pathology Laboratory, Trinity College Dublin, Dublin, Ireland
- Discipline of Histopathology, St. James' University Hospital, Trinity College Dublin, Dublin, Ireland
- Trinity St James Cancer Institute, Trinity College Dublin, Dublin, Ireland
| | - Linda Sharp
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | | | - John J O'Leary
- TCD CERVIVA Molecular Pathology Laboratory, Trinity College Dublin, Dublin, Ireland
- Discipline of Histopathology, St. James' University Hospital, Trinity College Dublin, Dublin, Ireland
- The Coombe Hospital, Dublin 8, Ireland
- Trinity St James Cancer Institute, Trinity College Dublin, Dublin, Ireland
| | - Cara M Martin
- TCD CERVIVA Molecular Pathology Laboratory, Trinity College Dublin, Dublin, Ireland
- Discipline of Histopathology, St. James' University Hospital, Trinity College Dublin, Dublin, Ireland
- The Coombe Hospital, Dublin 8, Ireland
- Trinity St James Cancer Institute, Trinity College Dublin, Dublin, Ireland
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