Most Read Articles
14 Oct 2017
In pregnant women, adherence to recommended dietary intake of fat and fibre is associated with a more beneficial and richer gut microbiota which, in turn, decreases levels of the inflammation marker glycoprotein acetylation (GlycA), a study has shown.
5 days ago
Elagolix is safe and effective for reducing heavy menstrual bleeding in females with fibroids, a new dose-ranging, multiple-cohort study has shown.
13 Oct 2017
Dr Joon Kiong Lee discusses pharmacotherapy for osteoporosis and the role of FLS in fracture prevention
Tristan Manalac, 06 Oct 2017
In women with polycystic ovary syndrome (PCOS), combined oral contraceptive (COC) with spironolactone is more effective than metformin in reducing symptoms while showing a similar safety profile, according to a new randomized clinical trial (RCT).

HPV genotyping with LBC trumps cytology for cervical screening in SG

23 Aug 2017
Singling out the DNA of HPV as a routine test proven to significantly locate pre-cancerous lesions

Human papillomavirus (HPV)+16/18 genotyping with reflex liquid-based cytology, compared to cytology, detects more cervical intraepithelial neoplasia grade 3 or worse (≥CIN3) and is cost-effective for cervical screening in Singapore, suggests a recent study.

A total of 1,866 women were included in the study; of these, 167 (8.9 percent) had abnormal cytology (≥ASCUS [atypical squamous cells of undetermined significance]) and 171 (9.2 percent) tested positive for high-risk HPV.

There were 23 CIN detected. Of the 10 ≥CIN3 cases, three had negative cytology but positive HPV-16.

Compared to cytology, HPV genotyping detected more ≥CIN3 (odds ratio, 1.43). Furthermore, HPV+16/18 genotyping with reflex LBC was superior to LBC with reflex HPV in terms of cost-effectiveness, both for disease detection rate and cost per case of ≥CIN2 detected.

Researchers retrospectively analysed women who were ≥25 years old and undertook cotesting with LBC and HPV-genotyping for HPV-16, HPV-18 and 12 high-risk HPV types in a single institution. A single cervical smear in ThinPrep PreservCyt solution was separated for tests in independent cytology and molecular pathology laboratories.

A designated gynaecologist reviewed the results based on institutional clinical management protocols. Those who tested positive for HPV-16 and/or HPV-18 (regardless of cytology results), cytology showing low-grade squamous intraepithelial lesions (SIL) or high-grade SIL, or ASCUS with positive 12 high-risk HPV types were referred for colposcopy.

A colposcopist determined cervical biopsy, either directed punch biopsies or excisional biopsy, and a gynaecologic pathologist reviewed the ≥CIN3 diagnosis.

Epidemiological, clinical and financial input data form Singapore were used to analyse the cost-effectiveness of HPV-based screening in terms of disease and financial burden.

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Most Read Articles
14 Oct 2017
In pregnant women, adherence to recommended dietary intake of fat and fibre is associated with a more beneficial and richer gut microbiota which, in turn, decreases levels of the inflammation marker glycoprotein acetylation (GlycA), a study has shown.
5 days ago
Elagolix is safe and effective for reducing heavy menstrual bleeding in females with fibroids, a new dose-ranging, multiple-cohort study has shown.
13 Oct 2017
Dr Joon Kiong Lee discusses pharmacotherapy for osteoporosis and the role of FLS in fracture prevention
Tristan Manalac, 06 Oct 2017
In women with polycystic ovary syndrome (PCOS), combined oral contraceptive (COC) with spironolactone is more effective than metformin in reducing symptoms while showing a similar safety profile, according to a new randomized clinical trial (RCT).