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- Title
The Role of High-Risk Human Papilloma Virus Testing in the Surveillance of Cervical Cancer After Treatment.
- Authors
Yu, Miao Crystal; Austin, R. Marshall; Lin, Jeff; Beck, Tiffany; Beriwal, Sushil; Comerci, John T.; Edwards, Robert P.; Sukumvanich, Paniti; Kelley, Joseph; Olawaiye, Alexander B.
- Abstract
Context.--Cervical cancer affects 12 000 women in the United States annually. However, despite its prevalence, there remains no good methodology to detect its recurrence. Objective.--To identify the role of cervicovaginal high-risk human papilloma virus (hr-HPV) testing in predicting cervical cancer recurrence. Design.--This is a retrospective study of patients who underwent hr-HPV testing as part of their routine surveillance for cervical cancer. Standard statistical analyses, including χ² test and multivariable logistic regression, were performed with IBM SPSS 19.0. Results.--A total of 133 patients were identified, of whom 107 (80%) had squamous cell carcinoma. Ninety patients (68%) had bulky disease and were treated primarily with chemoradiation and brachytherapy. Of patients whose disease recurred, 5 patients (42%) had tested positive for hr-HPV during their surveillance period, compared to 13 patients (11%) for whom disease did not recur (relative risk: 3.88, P = .002). On multivariate logistic regression, hr-HPV status remained significantly predictive of disease recurrence (odds ratio: 12.3, P = .02, 95% confidence interval: 1.5-99.6). Using 2 x 2 table analysis, we found that while cervicovaginal cytology has limited specificity (5.7%) in predicting recurrence, the combination of cytology with hr-HPV testing increases the specificity of testing to 89.3%. Conclusions.--Persistence of hr-HPV is a risk factor for disease recurrence. High-risk--HPV testing is not routinely used during surveillance for cervical cancer, but this study suggests that large, prospective trials investigating the role of hr-HPV testing in cervical cancer surveillance are needed.
- Subjects
CANCER relapse; CHI-squared test; CONFIDENCE intervals; CYTODIAGNOSIS; DEMOGRAPHY; FISHER exact test; PATIENT aftercare; MULTIVARIATE analysis; PAPILLOMAVIRUSES; PROBABILITY theory; SQUAMOUS cell carcinoma; T-test (Statistics); CERVIX uteri tumors; MULTIPLE regression analysis; RELATIVE medical risk; RETROSPECTIVE studies; DATA analysis software; ODDS ratio; DIAGNOSIS; CANCER risk factors
- Publication
Archives of Pathology & Laboratory Medicine, 2015, Vol 139, Issue 11, p1437
- ISSN
0003-9985
- Publication type
Article
- DOI
10.5858/arpa.2014-0534-OA