Use of HPV testing for cervical screening in vaccinated women - insights from the SHEVa (Scottish HPV Prevalence in Vaccinated Women) study

R Bhatia, K Kavanagh, H Cubie, I Serrano, H Wennington, M Hopkins, J Pan, KG Pollock, TJ Palmer, K Cuschieri

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

The management of cervical disease is changing worldwide as a result of HPV vaccination and the increasing use of HPV testing for cervical screening. However, the impact of vaccination on the performance of HPV based screening strategies is unknown. The SHEVa (Scottish HPV Prevalence in Vaccinated women) projects are designed to gain insight into the impact of vaccination on the performance of clinically validated HPV assays. Samples collated from women attending for first cervical smear who had been vaccinated as part of a national “catch up” programme were tested with three clinically validated HPV assays (2 DNA and 1 RNA). Overall HR-HPV and type specific positivity was assessed in total population and according to underlying cytology and compared to a demographically equivalent group of unvaccinated women. HPV prevalence was significantly lower in vaccinated women and was influenced by assay-type, reducing by 23-25% for the DNA based assays and 32% for the RNA assay (p=0.0008). All assays showed over 75% reduction of HPV16 and/or 18 (p<0.0001) whereas the prevalence of non 16/18 HR-HPV was not significantly different in vaccinated vs unvaccinated women. In women with low grade abnormalities, the proportion associated with non 16/18 HR-HPV was significantly higher in vaccinated women (p<0.0001). Clinically validated HPV assays are affected differentially when applied to vaccinated women, dependent on assay chemistry. The increased proportion of non HPV16 /18 infections may have implications for clinical performance, consequently, longitudinal studies linking HPV status to disease outcomes in vaccinated women are warranted.
LanguageEnglish
JournalInternational Journal of Cancer
Early online date4 Feb 2016
DOIs
Publication statusE-pub ahead of print - 4 Feb 2016

Fingerprint

Vaccination
Screening
Testing
Proportion
Longitudinal Study
Positivity
Chemistry
Linking
Infection
Human papillomavirus 18
Unknown
Dependent
RNA
Vaginal Smears
DNA
Disease Management
Longitudinal Studies
Cell Biology

Keywords

  • HPV immunisation
  • clinically validated HPV tests
  • cervical screening

Cite this

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title = "Use of HPV testing for cervical screening in vaccinated women - insights from the SHEVa (Scottish HPV Prevalence in Vaccinated Women) study",
abstract = "The management of cervical disease is changing worldwide as a result of HPV vaccination and the increasing use of HPV testing for cervical screening. However, the impact of vaccination on the performance of HPV based screening strategies is unknown. The SHEVa (Scottish HPV Prevalence in Vaccinated women) projects are designed to gain insight into the impact of vaccination on the performance of clinically validated HPV assays. Samples collated from women attending for first cervical smear who had been vaccinated as part of a national “catch up” programme were tested with three clinically validated HPV assays (2 DNA and 1 RNA). Overall HR-HPV and type specific positivity was assessed in total population and according to underlying cytology and compared to a demographically equivalent group of unvaccinated women. HPV prevalence was significantly lower in vaccinated women and was influenced by assay-type, reducing by 23-25{\%} for the DNA based assays and 32{\%} for the RNA assay (p=0.0008). All assays showed over 75{\%} reduction of HPV16 and/or 18 (p<0.0001) whereas the prevalence of non 16/18 HR-HPV was not significantly different in vaccinated vs unvaccinated women. In women with low grade abnormalities, the proportion associated with non 16/18 HR-HPV was significantly higher in vaccinated women (p<0.0001). Clinically validated HPV assays are affected differentially when applied to vaccinated women, dependent on assay chemistry. The increased proportion of non HPV16 /18 infections may have implications for clinical performance, consequently, longitudinal studies linking HPV status to disease outcomes in vaccinated women are warranted.",
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Use of HPV testing for cervical screening in vaccinated women - insights from the SHEVa (Scottish HPV Prevalence in Vaccinated Women) study. / Bhatia, R; Kavanagh, K; Cubie, H; Serrano, I; Wennington, H; Hopkins, M; Pan, J; Pollock, KG; Palmer, TJ; Cuschieri, K.

In: International Journal of Cancer, 04.02.2016.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Use of HPV testing for cervical screening in vaccinated women - insights from the SHEVa (Scottish HPV Prevalence in Vaccinated Women) study

AU - Bhatia, R

AU - Kavanagh, K

AU - Cubie, H

AU - Serrano, I

AU - Wennington, H

AU - Hopkins, M

AU - Pan, J

AU - Pollock, KG

AU - Palmer, TJ

AU - Cuschieri, K

PY - 2016/2/4

Y1 - 2016/2/4

N2 - The management of cervical disease is changing worldwide as a result of HPV vaccination and the increasing use of HPV testing for cervical screening. However, the impact of vaccination on the performance of HPV based screening strategies is unknown. The SHEVa (Scottish HPV Prevalence in Vaccinated women) projects are designed to gain insight into the impact of vaccination on the performance of clinically validated HPV assays. Samples collated from women attending for first cervical smear who had been vaccinated as part of a national “catch up” programme were tested with three clinically validated HPV assays (2 DNA and 1 RNA). Overall HR-HPV and type specific positivity was assessed in total population and according to underlying cytology and compared to a demographically equivalent group of unvaccinated women. HPV prevalence was significantly lower in vaccinated women and was influenced by assay-type, reducing by 23-25% for the DNA based assays and 32% for the RNA assay (p=0.0008). All assays showed over 75% reduction of HPV16 and/or 18 (p<0.0001) whereas the prevalence of non 16/18 HR-HPV was not significantly different in vaccinated vs unvaccinated women. In women with low grade abnormalities, the proportion associated with non 16/18 HR-HPV was significantly higher in vaccinated women (p<0.0001). Clinically validated HPV assays are affected differentially when applied to vaccinated women, dependent on assay chemistry. The increased proportion of non HPV16 /18 infections may have implications for clinical performance, consequently, longitudinal studies linking HPV status to disease outcomes in vaccinated women are warranted.

AB - The management of cervical disease is changing worldwide as a result of HPV vaccination and the increasing use of HPV testing for cervical screening. However, the impact of vaccination on the performance of HPV based screening strategies is unknown. The SHEVa (Scottish HPV Prevalence in Vaccinated women) projects are designed to gain insight into the impact of vaccination on the performance of clinically validated HPV assays. Samples collated from women attending for first cervical smear who had been vaccinated as part of a national “catch up” programme were tested with three clinically validated HPV assays (2 DNA and 1 RNA). Overall HR-HPV and type specific positivity was assessed in total population and according to underlying cytology and compared to a demographically equivalent group of unvaccinated women. HPV prevalence was significantly lower in vaccinated women and was influenced by assay-type, reducing by 23-25% for the DNA based assays and 32% for the RNA assay (p=0.0008). All assays showed over 75% reduction of HPV16 and/or 18 (p<0.0001) whereas the prevalence of non 16/18 HR-HPV was not significantly different in vaccinated vs unvaccinated women. In women with low grade abnormalities, the proportion associated with non 16/18 HR-HPV was significantly higher in vaccinated women (p<0.0001). Clinically validated HPV assays are affected differentially when applied to vaccinated women, dependent on assay chemistry. The increased proportion of non HPV16 /18 infections may have implications for clinical performance, consequently, longitudinal studies linking HPV status to disease outcomes in vaccinated women are warranted.

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KW - clinically validated HPV tests

KW - cervical screening

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T2 - International Journal of Cancer

JF - International Journal of Cancer

SN - 0020-7136

ER -