Assessing national cervical cancer screening guidelines: Results from an HIV testing clinic also screening for cervical cancer and HPV in Soweto, South Africa.
Assessing national cervical cancer screening guidelines: Results from an HIV testing clinic also screening for cervical cancer and HPV in Soweto, South Africa.
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DOI：
10.1371/journal.pone.0255124
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发表时间：
2021
期刊：
影响因子：
3.7
通讯作者：
Gray GE
中科院分区：
文献类型：
--
作者：
Hopkins KL;Jaffer M;Hlongwane KE;Otwombe K;Dietrich J;Cheyip M;Olivier J;Doherty T;Gray GE
南非索韦托（SA）的一个筛查中心调查了妇女中高危人乳头瘤病毒（HR-HPV）、艾滋病毒和宫颈癌的风险。这项横断面研究（2018年6月至2019年3月）描述了筛查结果（罗氏线阵HPV检测和巴氏涂片液基细胞学）和筛查史（已知HIV状态、抗逆转录病毒治疗[ART]使用、既往巴氏涂片）。数据按年龄组（18-29岁，30岁以上）、艾滋病毒状态、巴氏涂片结果分层，并进行统计学显著性检验。在280名妇女中，20.4%为HIV阳性，18.2%有异常的巴氏涂片，41.8%有HR-HPV。在老年妇女中，48.2%（n = 78/162）从未进行过巴氏涂片检查。在年轻妇女中，89.0%（n = 105/118）从未进行过巴氏涂片检查，但与老年妇女相比，有更多的低度鳞状上皮内病变（LSIL）和其他HR-HPV感染（分别为12.7%[n = 15/118] vs 4.9%[n = 8/162]，p = 0.0193; 49.2%[n = 58/118] vs 29.0%[n = 47/162]，p = 0.0006）。与HIV阴性女性相比，HIV阳性女性有更多的异常细胞学结果和其他HR-HPV类型的感染或其他HR-HPV类型/HPV-16的合并感染（35.1%[n = 20/57] vs 13.9%[n = 31/223]，p = 0.0002; 56.1%[n = 32/57] vs 32.7%[n = 73/223]，p = 0.001; 12.3%[n = 7/57] vs 4.9%[n = 11/223]，p = 0.044;分别）。在57名艾滋病毒阳性妇女中，45.6%（n = 26）已经知道自己的艾滋病毒状况;其中69.2%正在接受抗逆转录病毒治疗，34.6%从未做过巴氏涂片检查。南非妇女艾滋病毒、巴氏涂片异常和HR-HPV感染率很高，宫颈癌筛查覆盖率很低。SA宫颈癌筛查政策排除了（未确诊的）艾滋病毒阳性和艾滋病毒阴性的妇女<30岁，这两个人群发现HR-HPV的流行率很高。从25岁开始进行基于HPV的初步筛查可以改善结果。
A screening centre in Soweto, South Africa (SA), investigated high-risk human papillomavirus (HR-HPV), HIV, cervical cancer risk amongst women. This cross-sectional study (June 2018-March 2019) describes screening results (Roche Linear Array HPV test and Pap smear liquid based cytology) and history of screening (known HIV status, antiretroviral therapy [ART] use, previous Pap smears). Data were stratified by age group (18–29, 30+ years), HIV status, Pap smear results and tested for statistical significance. Of 280 women, 20.4% were HIV-positive, 18.2% had abnormal Pap smears, 41.8% had HR-HPV. Of older women, 48.2% (n = 78/162) had never had a Pap smear. Of younger women, 89.0% (n = 105/118) never had a Pap smear, but had significantly more low-grade squamous intraepithelial lesions (LSIL) and other HR-HPV infection than older women (12.7%[n = 15/118] vs 4.9%[n = 8/162], p = 0.0193; and 49.2%[n = 58/118] vs 29.0%[n = 47/162], p = 0.0006; respectively). HIV-positive women had more abnormal cytology results and infection with other HR-HPV types or co-infection with other HR-HPV type(s)/HPV-16 compared to HIV-negative women (35.1%[n = 20/57] vs 13.9%[n = 31/223], p = 0.0002; 56.1%[n = 32/57] vs 32.7%[n = 73/223], p = 0.001; and 12.3%[n = 7/57] vs 4.9%[n = 11/223], p = 0.044; respectively). Of 57 HIV-positive women, 45.6% (n = 26) already knew their HIV status; of which 69.2% were on ART and 34.6% never had a Pap smear. South African women have high rates of HIV, Pap smear abnormalities and HR-HPV, with low cervical cancer screening coverage. SA cervical cancer screening policy excludes (undiagnosed) HIV-positive and HIV-negative women <30 years, both populations found to have high prevalence of HR-HPV. HPV-based primary screening from 25 years could improve outcomes.
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影响因子：
6.4
作者：
Meijer, Chris J. L. M.;Berkhof, Johannes;Castle, Philip E.;Hesselink, Albertus T.;Franco, Eduardo L.;Ronco, Guglielmo;Arbyn, Marc;Bosch, F. Xavier;Cuzick, Jack;Dillner, Joakim;Heideman, Danielle A. M.;Snijders, Peter J. F.
通讯作者：
Snijders, Peter J. F.
DOI：
10.7196/samj.6514
发表时间：
2013-05-01
期刊：
SAMJ: South African Medical Journal
影响因子：
--
作者：
Richter, K;Becker, P;Dreyer, G
通讯作者：
Dreyer, G
影响因子：
3.7
作者：
Firnhaber, Cynthia;Mayisela, Nomtha;Smith, Jennifer S.
通讯作者：
Smith, Jennifer S.
影响因子：
10.3
作者：
Tsang, Sabrina H.;Sampson, Joshua N.;Herrero, Rolando
通讯作者：
Herrero, Rolando
影响因子：
5.1
作者：
Gilkey, Melissa B.;Moss, Jennifer L.;Brewer, Noel T.
通讯作者：
Brewer, Noel T.