Trial reportJournal of the National Cancer Institute2015
Informed cytology for triaging HPV-positive women: substudy nested in the NTCC randomized controlled trial.
Open access · bronzeAbstract readRandomized Controlled Trial
In one paragraph
Trial report in Journal of the National Cancer Institute, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers.
0numbers the graph read from it
0cells of the map it votes in
34citing papers in PubMed
8.1field-weighted citation impact, top 2% of its field
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
34 citing papers in PubMed, 80 citations in OpenAlex.
- Human papilloma virus genotyping for the cross-sectional and longitudinal probability of developing cervical intraepithelial neoplasia grade 2 or more.International journal of cancer · 2018Trial
- Triage Performance of FAM19A4/miR124-2 Methylation: 18-Month Follow-Up Results From a Prospective Observational Study Within the Dutch Primary HPV-Based Cervical Screening Program.International journal of cancer · 2026Observational
- Article
- Impact of knowledge of human papillomavirus positivity on cervical cytology performance in Latin America.Journal of the National Cancer Institute · 2025Article
- Triage performance of DNA methylation for women with high-risk human papillomavirus infection.The oncologist · 2025Article
- Triage performance of PAX1Clinical epigenetics · 2024Article
- Comparing the Costs and Diagnostic Outcomes of Replacing Cytology with the QIAsure DNA Methylation Test as a Triage within HPV Primary Cervical Cancer Screening in The Netherlands.Diagnostics (Basel, Switzerland) · 2023Article
- HPV testing in Polish population-based cervical cancer screening programme (HIPPO project)-study protocol of a randomised healthcare policy trial.BMC cancer · 2023Article
- Quantitative Proteomic Analysis of MCM3 in ThinPrep Samples of Patients with Cervical Preinvasive Cancer.International journal of molecular sciences · 2023Article
- Identification of a methylation panel as an alternative triage to detect CIN3+ in hrHPV-positive self-samples from the population-based cervical cancer screening programme.Clinical epigenetics · 2023Article
- CIN2 + detection in high-risk HPV patients with no or minor cervical cytologic abnormalities: a clinical approach validated by machine learning.Archives of gynecology and obstetrics · 2023Article
- Inter- and intraobserver agreement in whole-slide digital ThinPrep samples of low-grade squamous lesions of the cervix uteri with known high-risk HPV status: A multicentric international study.Cancer cytopathology · 2022Article
- DNA methylation-based detection and prediction of cervical intraepithelial neoplasia grade 3 and invasive cervical cancer with the WID™-qCIN test.Clinical epigenetics · 2022Article
- Cytology interpretation after a change to HPV testing in primary cervical screening: Observational study from the English pilot.Cancer cytopathology · 2022Observational
- Liquid-Based Screening Tests Results: HPV, Liquid-Based Cytology, and P16/Ki67 Dual-Staining in Private-Based Opportunistic Cervical Cancer Screening.Diagnostics (Basel, Switzerland) · 2021Article
- Methylation markers FAM19A4 and miR124-2 as triage strategy for primary human papillomavirus screen positive women: A large European multicenter study.International journal of cancer · 2021Article
- Article
- The impact of knowledge of HPV positivity on cytology triage in primary high-risk HPV screening.Journal of medical screening · 2019Article
- Article
- Budget impact analysis of cervical cancer screening in Portugal: comparison of cytology and primary HPV screening strategies.BMC public health · 2019Article
Corrections and comments
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Authors and funding
13 authors at 7 institutions in 2 countries.
Christine BergeronDepartment of Pathology, Laboratoire Cerba, Cergy Pontoise France (CB, FC); Servizio Interaziendale Epidemiologia, AUSL Reggio Emilia, Italy (PGR); Department of Pathology, S. Giovanni Hospital, Rome, Italy (MLS); Laboratory Department University Hospital "Città della Salute e della Scienza di Torino," Turin, Italy (BG); Department of Pathology, S. Chiara Hospital, Trento, Italy (PDP); Women's Health Department, University Hospital, Padua, Italy (DM); Veneto Oncology Institute IRCCS, Padua, Italy (MZ); Emilia-Romagna Region, Bologna, Italy (CN); Laboratory of Preventive Oncology, Institute for Cancer Study and Prevention (ISPO), Florence (MC); Department of Cancer Screening, Center for Epidemiology and Prevention in Oncology (CPO), University Hospital "Città della Salute e della Scienza di Torino," Turin, Italy (GR, NS, SR).
Paolo Giorgi-RossiDepartment of Pathology, Laboratoire Cerba, Cergy Pontoise France (CB, FC); Servizio Interaziendale Epidemiologia, AUSL Reggio Emilia, Italy (PGR); Department of Pathology, S. Giovanni Hospital, Rome, Italy (MLS); Laboratory Department University Hospital "Città della Salute e della Scienza di Torino," Turin, Italy (BG); Department of Pathology, S. Chiara Hospital, Trento, Italy (PDP); Women's Health Department, University Hospital, Padua, Italy (DM); Veneto Oncology Institute IRCCS, Padua, Italy (MZ); Emilia-Romagna Region, Bologna, Italy (CN); Laboratory of Preventive Oncology, Institute for Cancer Study and Prevention (ISPO), Florence (MC); Department of Cancer Screening, Center for Epidemiology and Prevention in Oncology (CPO), University Hospital "Città della Salute e della Scienza di Torino," Turin, Italy (GR, NS, SR).
Frederic CasDepartment of Pathology, Laboratoire Cerba, Cergy Pontoise France (CB, FC); Servizio Interaziendale Epidemiologia, AUSL Reggio Emilia, Italy (PGR); Department of Pathology, S. Giovanni Hospital, Rome, Italy (MLS); Laboratory Department University Hospital "Città della Salute e della Scienza di Torino," Turin, Italy (BG); Department of Pathology, S. Chiara Hospital, Trento, Italy (PDP); Women's Health Department, University Hospital, Padua, Italy (DM); Veneto Oncology Institute IRCCS, Padua, Italy (MZ); Emilia-Romagna Region, Bologna, Italy (CN); Laboratory of Preventive Oncology, Institute for Cancer Study and Prevention (ISPO), Florence (MC); Department of Cancer Screening, Center for Epidemiology and Prevention in Oncology (CPO), University Hospital "Città della Salute e della Scienza di Torino," Turin, Italy (GR, NS, SR).
Maria Luisa SchiboniDepartment of Pathology, Laboratoire Cerba, Cergy Pontoise France (CB, FC); Servizio Interaziendale Epidemiologia, AUSL Reggio Emilia, Italy (PGR); Department of Pathology, S. Giovanni Hospital, Rome, Italy (MLS); Laboratory Department University Hospital "Città della Salute e della Scienza di Torino," Turin, Italy (BG); Department of Pathology, S. Chiara Hospital, Trento, Italy (PDP); Women's Health Department, University Hospital, Padua, Italy (DM); Veneto Oncology Institute IRCCS, Padua, Italy (MZ); Emilia-Romagna Region, Bologna, Italy (CN); Laboratory of Preventive Oncology, Institute for Cancer Study and Prevention (ISPO), Florence (MC); Department of Cancer Screening, Center for Epidemiology and Prevention in Oncology (CPO), University Hospital "Città della Salute e della Scienza di Torino," Turin, Italy (GR, NS, SR).
Bruno GhiringhelloDepartment of Pathology, Laboratoire Cerba, Cergy Pontoise France (CB, FC); Servizio Interaziendale Epidemiologia, AUSL Reggio Emilia, Italy (PGR); Department of Pathology, S. Giovanni Hospital, Rome, Italy (MLS); Laboratory Department University Hospital "Città della Salute e della Scienza di Torino," Turin, Italy (BG); Department of Pathology, S. Chiara Hospital, Trento, Italy (PDP); Women's Health Department, University Hospital, Padua, Italy (DM); Veneto Oncology Institute IRCCS, Padua, Italy (MZ); Emilia-Romagna Region, Bologna, Italy (CN); Laboratory of Preventive Oncology, Institute for Cancer Study and Prevention (ISPO), Florence (MC); Department of Cancer Screening, Center for Epidemiology and Prevention in Oncology (CPO), University Hospital "Città della Salute e della Scienza di Torino," Turin, Italy (GR, NS, SR).
Paolo Dalla PalmaDepartment of Pathology, Laboratoire Cerba, Cergy Pontoise France (CB, FC); Servizio Interaziendale Epidemiologia, AUSL Reggio Emilia, Italy (PGR); Department of Pathology, S. Giovanni Hospital, Rome, Italy (MLS); Laboratory Department University Hospital "Città della Salute e della Scienza di Torino," Turin, Italy (BG); Department of Pathology, S. Chiara Hospital, Trento, Italy (PDP); Women's Health Department, University Hospital, Padua, Italy (DM); Veneto Oncology Institute IRCCS, Padua, Italy (MZ); Emilia-Romagna Region, Bologna, Italy (CN); Laboratory of Preventive Oncology, Institute for Cancer Study and Prevention (ISPO), Florence (MC); Department of Cancer Screening, Center for Epidemiology and Prevention in Oncology (CPO), University Hospital "Città della Salute e della Scienza di Torino," Turin, Italy (GR, NS, SR).
Daria MinucciDepartment of Pathology, Laboratoire Cerba, Cergy Pontoise France (CB, FC); Servizio Interaziendale Epidemiologia, AUSL Reggio Emilia, Italy (PGR); Department of Pathology, S. Giovanni Hospital, Rome, Italy (MLS); Laboratory Department University Hospital "Città della Salute e della Scienza di Torino," Turin, Italy (BG); Department of Pathology, S. Chiara Hospital, Trento, Italy (PDP); Women's Health Department, University Hospital, Padua, Italy (DM); Veneto Oncology Institute IRCCS, Padua, Italy (MZ); Emilia-Romagna Region, Bologna, Italy (CN); Laboratory of Preventive Oncology, Institute for Cancer Study and Prevention (ISPO), Florence (MC); Department of Cancer Screening, Center for Epidemiology and Prevention in Oncology (CPO), University Hospital "Città della Salute e della Scienza di Torino," Turin, Italy (GR, NS, SR).
Stefano RossoDepartment of Pathology, Laboratoire Cerba, Cergy Pontoise France (CB, FC); Servizio Interaziendale Epidemiologia, AUSL Reggio Emilia, Italy (PGR); Department of Pathology, S. Giovanni Hospital, Rome, Italy (MLS); Laboratory Department University Hospital "Città della Salute e della Scienza di Torino," Turin, Italy (BG); Department of Pathology, S. Chiara Hospital, Trento, Italy (PDP); Women's Health Department, University Hospital, Padua, Italy (DM); Veneto Oncology Institute IRCCS, Padua, Italy (MZ); Emilia-Romagna Region, Bologna, Italy (CN); Laboratory of Preventive Oncology, Institute for Cancer Study and Prevention (ISPO), Florence (MC); Department of Cancer Screening, Center for Epidemiology and Prevention in Oncology (CPO), University Hospital "Città della Salute e della Scienza di Torino," Turin, Italy (GR, NS, SR).
Manuel ZorziDepartment of Pathology, Laboratoire Cerba, Cergy Pontoise France (CB, FC); Servizio Interaziendale Epidemiologia, AUSL Reggio Emilia, Italy (PGR); Department of Pathology, S. Giovanni Hospital, Rome, Italy (MLS); Laboratory Department University Hospital "Città della Salute e della Scienza di Torino," Turin, Italy (BG); Department of Pathology, S. Chiara Hospital, Trento, Italy (PDP); Women's Health Department, University Hospital, Padua, Italy (DM); Veneto Oncology Institute IRCCS, Padua, Italy (MZ); Emilia-Romagna Region, Bologna, Italy (CN); Laboratory of Preventive Oncology, Institute for Cancer Study and Prevention (ISPO), Florence (MC); Department of Cancer Screening, Center for Epidemiology and Prevention in Oncology (CPO), University Hospital "Città della Salute e della Scienza di Torino," Turin, Italy (GR, NS, SR).
Carlo NaldoniDepartment of Pathology, Laboratoire Cerba, Cergy Pontoise France (CB, FC); Servizio Interaziendale Epidemiologia, AUSL Reggio Emilia, Italy (PGR); Department of Pathology, S. Giovanni Hospital, Rome, Italy (MLS); Laboratory Department University Hospital "Città della Salute e della Scienza di Torino," Turin, Italy (BG); Department of Pathology, S. Chiara Hospital, Trento, Italy (PDP); Women's Health Department, University Hospital, Padua, Italy (DM); Veneto Oncology Institute IRCCS, Padua, Italy (MZ); Emilia-Romagna Region, Bologna, Italy (CN); Laboratory of Preventive Oncology, Institute for Cancer Study and Prevention (ISPO), Florence (MC); Department of Cancer Screening, Center for Epidemiology and Prevention in Oncology (CPO), University Hospital "Città della Salute e della Scienza di Torino," Turin, Italy (GR, NS, SR).
Nereo SegnanDepartment of Pathology, Laboratoire Cerba, Cergy Pontoise France (CB, FC); Servizio Interaziendale Epidemiologia, AUSL Reggio Emilia, Italy (PGR); Department of Pathology, S. Giovanni Hospital, Rome, Italy (MLS); Laboratory Department University Hospital "Città della Salute e della Scienza di Torino," Turin, Italy (BG); Department of Pathology, S. Chiara Hospital, Trento, Italy (PDP); Women's Health Department, University Hospital, Padua, Italy (DM); Veneto Oncology Institute IRCCS, Padua, Italy (MZ); Emilia-Romagna Region, Bologna, Italy (CN); Laboratory of Preventive Oncology, Institute for Cancer Study and Prevention (ISPO), Florence (MC); Department of Cancer Screening, Center for Epidemiology and Prevention in Oncology (CPO), University Hospital "Città della Salute e della Scienza di Torino," Turin, Italy (GR, NS, SR).
Massimo ConfortiniDepartment of Pathology, Laboratoire Cerba, Cergy Pontoise France (CB, FC); Servizio Interaziendale Epidemiologia, AUSL Reggio Emilia, Italy (PGR); Department of Pathology, S. Giovanni Hospital, Rome, Italy (MLS); Laboratory Department University Hospital "Città della Salute e della Scienza di Torino," Turin, Italy (BG); Department of Pathology, S. Chiara Hospital, Trento, Italy (PDP); Women's Health Department, University Hospital, Padua, Italy (DM); Veneto Oncology Institute IRCCS, Padua, Italy (MZ); Emilia-Romagna Region, Bologna, Italy (CN); Laboratory of Preventive Oncology, Institute for Cancer Study and Prevention (ISPO), Florence (MC); Department of Cancer Screening, Center for Epidemiology and Prevention in Oncology (CPO), University Hospital "Città della Salute e della Scienza di Torino," Turin, Italy (GR, NS, SR).
Guglielmo RoncoDepartment of Pathology, Laboratoire Cerba, Cergy Pontoise France (CB, FC); Servizio Interaziendale Epidemiologia, AUSL Reggio Emilia, Italy (PGR); Department of Pathology, S. Giovanni Hospital, Rome, Italy (MLS); Laboratory Department University Hospital "Città della Salute e della Scienza di Torino," Turin, Italy (BG); Department of Pathology, S. Chiara Hospital, Trento, Italy (PDP); Women's Health Department, University Hospital, Padua, Italy (DM); Veneto Oncology Institute IRCCS, Padua, Italy (MZ); Emilia-Romagna Region, Bologna, Italy (CN); Laboratory of Preventive Oncology, Institute for Cancer Study and Prevention (ISPO), Florence (MC); Department of Cancer Screening, Center for Epidemiology and Prevention in Oncology (CPO), University Hospital "Città della Salute e della Scienza di Torino," Turin, Italy (GR, NS, SR). guglielmo.ronco@cpo.it.
Istituto Oncologico Veneto · ITAzienda Sanitaria Unità Locale di Reggio Emilia · ITInstitute for Cancer Prevention · USIstituti di Ricovero e Cura a Carattere Scientifico · ITOspedale Santa Chiara · ITAzienda Ospedaliera Citta' della Salute e della Scienza di Torino · ITRegione Emilia-Romagna
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHuman papillomavirus (HPV)-based screening needs triage. In most randomized controlled trials (RCTs) on HPV testing with cytological triage, cytology interpretation has been blind to HPV status.
methodsWomen age 25 to 60 years enrolled in the New Technology in Cervical Cancer (NTCC) RCT comparing HPV testing with cytology were referred to colposcopy if HPV positive and, if no cervical intraepithelial neoplasia (CIN) was detected, followed up until HPV negativity. Cytological slides taken at the first colposcopy were retrieved and independently interpreted by an external laboratory, which was only aware of patients' HPV positivity. Sensitivity, specificity, and positive (PPV) and negative (NPV) predictive values were computed for histologically proven CIN2+ with HPV status-informed cytology for women with a determination of atypical squamous cells of undetermined significance (ASCUS) or more severe. All statistical tests were two-sided.
resultsAmong HPV-positive women, informed cytology had cross-sectional sensitivity, specificity, PPV and 1-NPV for CIN2+ of 85.6% (95% confidence interval [CI] = 76.6 to 92.1), 65.9% (95% CI = 63.1 to 68.6), 16.2% (95% CI = 13.0 to 19.8), and 1.7 (95% CI = 0.9 to 2.8), respectively. Cytology was also associated with subsequent risk of newly diagnosed CIN2+ and CIN3+. The cross-sectional relative sensitivity for CIN2+ vs blind cytology obtained by referring to colposcopy and following up only HPV positive women who had HPV status-informed cytology greater than or equal to ASCUS was 1.58 (95% CI = 1.22 to 2.01), while the corresponding relative referral to colposcopy was 0.95 (95% CI = 0.86 to 1.04).
conclusionsCytology informed of HPV positivity is more sensitive than blind cytology and could allow longer intervals before retesting HPV-positive, cytology-negative women.
Indexed as
AlphapapillomavirusAtypical Squamous Cells of the CervixColposcopyTriageVaginal SmearsAdultFemaleHumansMass ScreeningMiddle AgedPapillomavirus InfectionsPredictive Value of TestsSensitivity and SpecificityUterine Cervical DysplasiaUterine Cervical Neoplasms
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