Evidence map›Paper›PMID 30542667›Full record

ArticleJournal of global health reports2018

Randomized controlled trial evaluating the utility of urine HPV DNA for cervical cancer screening in a Pacific Island population.

Brenda Y Hernandez, Aileen C Tareg, Martina Reichhardt, Angelica Agapito, Xuemei Zhu, Angela Sy, Arnice Yuji, Jeffrey Killeen, Owen Chan, Lee E Buenconsejo-Lum

Open access · goldAbstract read
In one paragraph

Article in Journal of global health reports, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
0.8field-weighted citation impact, top 26% of its field
1 · What the graph read from it

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 11 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Review
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 2 institutions in 1 country.

Brenda Y HernandezUniversity of Hawaii Cancer Center, Honolulu, Hawaii, USA.
Aileen C TaregPublic Health, Colonia, Yap, Micronesia (the Federated States of).
Martina ReichhardtYap State Department of Health Services, Colonia, Yap, Micronesia (Federated States of).
Angelica AgapitoWaab Community Health Center, Colonia, Yap, Micronesia (the Federated States of).
Xuemei ZhuUniversity of Hawaii Cancer Center, Honolulu, Hawaii, USA.
Angela SyJohn A. Burns School of Medicine, Honolulu, Hawaii, USA.
Arnice YujiJohn A. Burns School of Medicine, Pacific Programs, Honolulu, Hawaii, USA.
Jeffrey KilleenKapiolani Medical Center for Women and Children, Honolulu, Hawaii, USA.
Owen ChanUniversity of Hawaii Cancer Center, Honolulu, Hawaii, USA.
Lee E Buenconsejo-LumJohn A. Burns School of Medicine, Honolulu, Hawaii, USA.
University of Hawaiʻi at Mānoa · USKapiolani Medical Center for Women and Children · US

Funding

University of Hawaii Cancer Center CCSGP30CA071789 · NCI · UNIVERSITY OF HAWAII AT MANOA · PI Xin Chen · 1996 to 2026
$56.2M
Racial and Ethnic Approaches to Community Health USU58DP000976 · DP · UNIVERSITY OF HAWAII AT MANOA · PI PALAFOX, NEAL A. · 2007 to 2011
$4.2M
FSM NATIONAL AND STATES COMPREHENSIVE CANCER CONTROL PROGRAMU58DP000779 · DP · FEDERATED STATES MICRONESIA · PI SKILLING, VITA AKAPITO · 2007 to 2011
$2.5M
USAPI PACIFIC REGIONAL CENTRAL CANCER REGISTRY (PRCCR)U58DP003906 · DP · UNIVERSITY OF HAWAII AT MANOA · PI BUENCONSEJO-LUM, LEE ELLEN · 2012 to 2014
$1.6M
NCCDPHP CDC HHS U58 DP000779NCCDPHP CDC HHS U58 DP000976NCCDPHP CDC HHS U58 DP003906NCI NIH HHS P30 CA071789
6 · The paper itself

Abstract

backgroundNon-invasive, self-collection sampling methods for human papillomavirus (HPV) DNA detection have the potential to address logistical and cultural barriers to Pap screening, particularly in under resourced settings such as Yap state in the Federated States of Micronesia - a population with low levels of screening and high incidence of cervical cancer.

methodsA randomized controlled trial was conducted among adult women in Yap to compare cervical HPV DNA in self-collected urine and clinician-collected liquid cytology. Adult women aged 21-65 (n=217) were randomized by the order of sample collection. Concordance of HPV DNA, evaluated by the Roche Linear Array, was compared in paired self-collected urine and clinician-collected liquid cytology samples. The sensitivity and specificity of urine HPV DNA for prediction of cervical HPV and abnormal cytology was also evaluated. p16 in urine cytology samples was additionally assessed.

resultsOverall, HPV DNA detection was significantly lower in urine than cervical samples for any HPV (27.8% and 38.3%, respectively) and high-risk HPV (15.1% and 23.8%, respectively). For paired samples, there was moderate agreement for the overall study population (Kappa=0.54, 95% confidence interval CI=0.40-0.68) and substantial agreement for women >40 years (Kappa=0.65, 95% CI=0.46-0.85). The sensitivity and specificity of urine for the detection of cervical high-risk HPV was 51.0% and 96.2%, respectively. The sensitivities of HPV DNA in urine and liquid cytology for prediction of abnormal cytology (ASCUS/LSIL/HSIL) were 47.4% (95% CI=31.0-64.2) and 57.9% (95% CI=40.8-73.7), respectively; specificities were 92.0% (95% CI=86.9%-95.5%) and 83.5% (95% CI=77.2-88.7). Urine p16 was poorly correlated with urine HPV DNA positivity.

conclusionsUrine is less sensitive but more specific than directed cervical sampling for detection of cytologic abnormalities and may have utility for screening in older populations within low-resource communities when clinically-collected samples cannot be obtained.

Identifiers

PMID30542667
PMCPMC6287926
OpenAlexW2852343141

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.