ArticleBJOG : an international journal of obstetrics and gynaecology2020
Reflex cytology for triage of high-risk human papillomavirus positive self-sampled material in cervical cancer screening: a prospective cohort study.
Article in BJOG : an international journal of obstetrics and gynaecology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 2 of them syntheses that pooled it.
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13 citing papers in PubMed, 2 syntheses or guidelines pooled it, 21 citations in OpenAlex.
- Assessment of HPV screening modalities within primary care: a systematic review.Frontiers in medicine · 2025Pooled it
- Failure to follow up abnormal test results associated with cervical cancer in primary and ambulatory care: a systematic review.BMC cancer · 2023Pooled it
- Nationwide Study on the Cervical Cancer Screening Pathway in Estonia.International journal of cancer · 2026Article
- Integrated Cervical Self-Sampling for Cytology, High-Risk Human Papillomavirus, and Sexually Transmitted Infection Testing: A Prospective Study.Diagnostics (Basel, Switzerland) · 2026Article
- Untimely follow-up after cervical cancer screening: A qualitative study among healthcare providers in Flanders (Belgium).PloS one · 2026Article
- Viability of Self-Taken Vaginal Swab Samples for RNA-Based Biomarker Analysis in Cervical Disease.Journal of medical virology · 2025Article
- Human Papillomavirus Genotype Detection and Cytology Using a New Self-Sampling Method.Asian Pacific journal of cancer prevention : APJCP · 2024Article
- 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
- Does full HPV genotyping perform similarly well in clinician-collected cervical samples and self-collected vaginal samples when using the CLART HPV4S assay?BMC women's health · 2023Article
- Validity and acceptance of self vs conventional sampling for the analysis of human papillomavirus and Pap smear.Scientific reports · 2023Article
- The added value of digital imaging to reflex cytology for triage of high-risk human papillomavirus positive self-sampled material in cervical cancer screening: A prospective cohort study.BJOG : an international journal of obstetrics and gynaecology · 2023Article
- Cervical Cancer Screening Postpandemic: Self-Sampling Opportunities to Accelerate the Elimination of Cervical Cancer.International journal of women's health · 2021Review
- Reflex cytology for triage of high-risk human papillomavirus positive self-sampled material in cervical cancer screening: a prospective cohort study.BJOG : an international journal of obstetrics and gynaecology · 2020Article
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Authors and funding
7 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveHigh-risk human papillomavirus (HrHPV)-positive women detected by self-sampling require an extra visit at the general practitioner for additional cytology testing, but the loss to follow up within this triage is substantial. The aim of this study was to evaluate the clinical utility of reflex cytology on hrHPV-positive self-samples for immediate stratification of women who need referral for colposcopy.
designA prospective cohort study.
settingTwo Dutch cervical cancer-screening laboratories. POPULATION: 1014 screenees who tested hrHPV-positive on self-samples between 1 December 2018 and 1 August 2019.
methodsSelf-samples were directly used for cytological analysis. Cytological and histological outcomes during follow up were obtained from the Dutch Pathology Registry (PALGA).
main outcome measuresTest performance of reflex cytology on self-samples was determined for different thresholds and compared with physician-taken cytology and histological outcomes.
resultsReflex cytology on self-samples for detecting abnormal cytology showed a sensitivity of 26.4% (95% CI 21.8-31.3) and specificity of 90.5% (95% CI 87.7-92.8). Of all ≥CIN2 cases, 29.4% (95% CI 22.5-37.1) were detected with reflex cytology on self-samples. The positive predictive value for detection of ≥CIN2 was higher with cytology on self-collected samples than on physician-collected samples. Of women who were lost to follow up, 12.9% were found to have abnormal cytology on their self-sampled material.
conclusionCytology testing is achievable on hrHPV-positive self-samples, could decrease the loss to follow up in screening and is easily implementable in the current clinical practice. Of all hrHPV-positive women with abnormal cytology on additional physician-collected samples, 26.4% could have been directly referred for colposcopy if triage with reflex cytology on self-sampled material had been performed. TWEETABLE ABSTRACT: Reflex cytology for triage of hrHPV
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