HPV for cervical cancer screening (HPV FOCAL): complete round 1 results of a randomized trial comparing HPV-based primary screening to liquid-based cytology for cervical cancer
Open accessAbstract
Complete Round 1 data (baseline and 12‐month follow‐up) for HPV FOCAL, a randomized trial establishing the efficacy of HPV DNA testing with cytology triage as a primary screen for cervical cancer are presented. Women were randomized to one of three arms: Control arm – Baseline liquid‐based cytology (LBC) with ASCUS results triaged with HPV testing; Intervention and Safety arms – Baseline HPV with LBC triage for HPV positives. Results are presented for 15,744 women allocated to the HPV (intervention and safety combined) and 9,408 to the control arms. For all age cohorts, the CIN3+ detection rate was higher in the HPV (7.5/1,000; 95%CI: 6.2, 8.9) compared to the control arm (4.6/1,000; 95%CI: 3.4, 6.2). The CIN2+ detection rates were also significantly higher in the HPV (16.5/1,000; 95%CI: 14.6, 18.6) vs . the control arm (10.1/1,000; 95%CI: 8.3, 12.4). In women ≥35 years, the overall detection rates for CIN2+ and CIN3+ were higher in the HPV vs . the control arm (CIN2+:10.0/1,000 vs . 5.2/1,000; CIN3+: 4.2/1,000 vs . 2.2/1,000 respectively, with a statistically significant difference for CIN2+). HPV testing detected significantly more CIN2+ in women 25–29 compared to LBC (63.7/1,000; 95%CI: 51.9, 78.0 vs . 32.4/1,000; 95%CI: 22.3, 46.8). HPV testing resulted in significantly higher colposcopy referral rates for all age cohorts (HPV: 58.9/1,000; 95%CI: 55.4, 62.7 vs . control: 30.9/1,000; 95%CI: 27.6, 34.6). At completion of Round 1 HPV‐based cervical cancer screening in a population‐based program resulted in greater CIN2+ detection of across all age cohorts compared to LBC screening.
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- Authors
- Ogilvie, G. S., Krajden, M., van Niekerk, D., Smith, L. W., Cook, D., Ceballos, K., Lee, M., Gentile, L., Gondara, L., Elwood‐Martin, R., Peacock, S., Stuart, G., Franco, E. L., & Coldman, A. J.
- Affiliations
- University of British Columbia (CA)
- Lower Mainland Laboratories Vancouver BC Canada
- BC Cancer Agency (CA)
- McGill University (CA)
- Corresponding author
- Ogilvie, Gina S.
- ORCID
- Venue
- International Journal of Cancer
- Publisher
- Wiley
- Published
- 2016-10-20
- Volume
- 140
- Issue
- 2
- Pages
- 440-448
- ISSN
- 0020-7136 (ISSN-L)
- 1097-0215
- OpenAlex
- W2526320839
- Cited by
- 101
- References
- 30
- Citations by year
- 2026: 6 · 2025: 5 · 2024: 5 · 2023: 8 · 2022: 9 · 2021: 18 · 2020: 11 · 2019: 13 · 2018: 15 · 2017: 9 · 2016: 2
- FWCI
- 12.19
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- International Journal of Cancer (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Cervical Cancer and HPV Research
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Women's cancer prevention and management
- Health Sciences › Medicine › Obstetrics and Gynecology › Endometrial and Cervical Cancer Treatments
- Keywords
- cervical cancer screening, HPV testing, primary screening, liquid-based cytology, cervical intraepithelial neoplasia, CIN2+ detection, CIN3+ detection, colposcopy referral, women aged 25-29, screening efficacy, cost-effectiveness, cervical cancer prevention
- MeSH terms
- Adult, Aged, Uterine Cervical Neoplasms, Colposcopy, DNA, Viral, Female, Humans, Mass Screening, Middle Aged, Referral and Consultation, Sensitivity and Specificity, Triage, Vaginal Smears, Papillomaviridae, Papillomavirus Infections, Early Detection of Cancer
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