Evidence map›Paper›PMID 30728133›Full record

Observational studyBMJ (Clinical research ed.)2019

Primary cervical screening with high risk human papillomavirus testing: observational study.

Matejka Rebolj, Janet Rimmer, Karin Denton, John Tidy, Christopher Mathews, Kay Ellis, John Smith, Chris Evans, Thomas Giles, Viki Frew and 12 more

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in BMJ (Clinical research ed.), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 91 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
91citing papers in PubMed, 5 pooled it
–field-weighted citation impact
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

91 citing papers in PubMed, 5 syntheses or guidelines pooled it.

  1. Pooled it
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  6. Trial
  7. Randomized Implementation of a Primary Human Papillomavirus Testing-based Cervical Cancer Screening Protocol for Women 34 to 69 Years in Norway.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2022
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31 more citing papers are in PubMed but not listed here.

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

22 authors.

Matejka ReboljCentre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Barts & The London School of Medicine and Dentistry, Queen Mary University of London, London, UK matejka.rebolj@kcl.ac.uk.ORCID http://orcid.org/0000-0001-9597-645X
Janet RimmerYoung Person and Adult Screening Programmes, Public Health England, Sheffield, UK.
Karin DentonPHE Screening Quality Assurance Service South, Public Health England, Bristol, UK.
John TidyDepartment of Gynaecological Oncology, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
Christopher MathewsCentre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Barts & The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
Kay EllisCytology, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
John SmithCytology, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
Chris EvansNHS Liverpool Clinical Laboratories, Royal Liverpool University Hospital, Liverpool, UK.
Thomas GilesNHS Liverpool Clinical Laboratories, Royal Liverpool University Hospital, Liverpool, UK.
Viki FrewDepartment of Cellular Pathology, Norfolk & Norwich University Hospitals NHS Foundation Trust, Norwich, UK.
Xenia TylerDepartment of Cellular Pathology, Norfolk & Norwich University Hospitals NHS Foundation Trust, Norwich, UK.
Alexandra SargentClinical Virology, Manchester University NHS Foundation Trust, Manchester, UK.
Janet ParkerCellular Pathology, Manchester University NHS Foundation Trust, Manchester, UK.
Miles HolbrookCellular Pathology, Manchester University NHS Foundation Trust, Manchester, UK.
Katherine HuntSevern Pathology, Southmead Hospital, North Bristol NHS Trust, Bristol, UK.
Penny TidburySevern Pathology, Southmead Hospital, North Bristol NHS Trust, Bristol, UK.
Tanya LevineDepartment of Cellular Pathology, Northwick Park Hospital, London, UK.
David SmithDepartment of Cellular Pathology, Northwick Park Hospital, London, UK.
Julietta PatnickCancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Ruth StubbsYoung Person and Adult Screening Programmes, Public Health England, Sheffield, UK.
Sue MossCentre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Barts & The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
Henry KitchenerDivision of Cancer Sciences, University of Manchester and Manchester NIHR BRC, Manchester, UK.

Funding

Cancer Research UK 16892Cancer Research UK 27047
6 · The paper itself

Abstract

objectiveTo provide the first report on the main outcomes from the prevalence and incidence rounds of a large pilot of routine primary high risk human papillomavirus (hrHPV) testing in England, compared with contemporaneous primary liquid based cytology screening.

designObservational study.

settingThe English Cervical Screening Programme.

participants578 547 women undergoing cervical screening in primary care between May 2013 and December 2014, with follow-up until May 2017; 183 970 (32%) were screened with hrHPV testing.

interventionsRoutine cervical screening with hrHPV testing with liquid based cytology triage and two early recalls for women who were hrHPV positive and cytology negative, following the national screening age and interval recommendations.

main outcome measuresFrequency of referral for a colposcopy; adherence to early recall; and relative detection of cervical intraepithelial neoplasia grade 2 or worse from hrHPV testing compared with liquid based cytology in two consecutive screening rounds.

resultsBaseline hrHPV testing and early recall required approximately 80% more colposcopies, (adjusted odds ratio 1.77, 95% confidence interval 1.73 to 1.82), but detected substantially more cervical intraepithelial neoplasia than liquid based cytology (1.49 for cervical intraepithelial neoplasia grade 2 or worse, 1.43 to 1.55; 1.44 for cervical intraepithelial neoplasia grade 3 or worse, 1.36 to 1.51) and for cervical cancer (1.27, 0.99 to 1.63). Attendance at early recall and colposcopy referral were 80% and 95%, respectively. At the incidence screen, the 33 506 women screened with hrHPV testing had substantially less cervical intraepithelial neoplasia grade 3 or worse than the 77 017 women screened with liquid based cytology (0.14, 0.09 to 0.23).

conclusionsIn England, routine primary hrHPV screening increased the detection of cervical intraepithelial neoplasia grade 3 or worse and cervical cancer by approximately 40% and 30%, respectively, compared with liquid based cytology. The very low incidence of cervical intraepithelial neoplasia grade 3 or worse after three years supports extending the screening interval.

Indexed as

AdultCervix UteriColposcopyCytological TechniquesEarly Detection of CancerEnglandFemaleHumansIncidenceMiddle AgedPapillomaviridaePapillomavirus InfectionsPilot ProjectsPredictive Value of TestsPrevalenceRisk Assessment

Identifiers

PMID30728133
PMCPMC6364146

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.