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Evaluation of triage strategies for high-risk human papillomavirus-positive women in cervical cancer screening: A multicenter randomized controlled trial in different resource settings in China

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收录情况： ◇ SCIE ◇ 统计源期刊 ◇ CSCD-C ◇ 卓越：梯队期刊

作者：
Dang Le[1,2] ; Kong Linghua[1] ; Zhao Yuqian[3] ; Dai Yi[1] ; Ma Li[4] ; Wei Lihui[5] ; Zhang Shulan[6] ; Liu Jihong[7] ; Xi Mingrong[8] ; Chen Long[9] ; Duan Xianzhi[10] ; Xiao Qing[11] ; Abulizi Guzhalinuer[12] ; Zhang Guonan[13] ; Hong Ying[14] ; Zhou Qi[15] ; Xie Xing[16] ; Li Li[17] ; Niyazi Mayinuer[18] ; Zhang Zhifen[19] ; Tuo Jiyu[20] ; Ding Yiling[21] ; Qiao Youlin[22,*1] ; Lang Jinghe[1,*2] ;
机构： [1]Department of Gynecology and Obstetrics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing 100730, China. [2]National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China. [3]Center for Cancer Prevention Research, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610041, China. [4]Department of Epidemiology, Dalian Medical University, Dalian 116044, China. [5]Department Obstetrics and Gynecology, Peking University People's Hospital, Beijing 100044, China. [6]Department of Obstetrics and Gynecology, Shengjing Hospital Affiliated to China Medical University, Shenyang 110004, China. [7]Department of Gynecology and Obstetrics, Sun Yat-sen University Cancer Center, Guangzhou 510060, China. [8]Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu 610041, China. [9]Department of Gynecology and Obstetrics, Zhejiang Xiaoshan Hospital Affiliated to Hangzhou Normal University, Chinese Academy of Medical Sciences/Zhejiang Xiaoshan Hospital Affiliated to Hangzhou Normal University, Hangzhou 310000, China. [10]Department of Obstetrics and Gynecology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China. [11]Department of Gynecology and Obstetrics, the Eight Affiliated Hospital Sun Yat-sen University, Shenzhen 518000, China. [12]5th Department of Gynecology, the Affiliated Cancer Hospital of Xinjiang Medical University, Urumqi 830011, China. [13]Department of Gynecologic Oncology, Sichuan Cancer Hospital &amp [14]Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610041, China. [14]Department of Gynecology and Obstetrics, Nanjing Drum Tower Hospital, Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China. [15]Department of Gynecological Oncology, Chongqing University Cancer Hospital/Chongqing Cancer Hospital, Chongqing 400030, China. [16]Department of Gynecologic Oncology, Women's Hospital, School of Medicine Zhejiang University, Hangzhou 310006, China. [17]Department of Gynecology and Obstetrics, Tumor Hospital of Guangxi Zhuang Autonomous Region, Nanning 530021, China. [18]Department of Gynecology, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830000, China. [19]Department of Gynecology, Hangzhou Women's Hospital, Hangzhou 310016, China. [20]Department of Gynecology and Obstetrics, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430079, China. [21]Department of Gynecology and Obstetrics, the Second Xiangya Hospital of Central South University, Changsha 410011, China. [22]School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100005, China.
出处：
DOI： 10.21147/j.issn.1000-9604.2022.05.09
ISSN：

摘要：
We aimed to evaluate the effectiveness of different triage strategies for high-risk human papillomavirus (hrHPV)-positive women in primary healthcare settings in China.This study was undertaken in 11 rural and 9 urban sites. Women aged 35-64 years old were enrolled. HrHPV-positive women were randomly allocated to liquid-based cytology (LBC), visual inspection with acetic acid and Lugol's iodine (VIA/VILI) (rural only) triage, or directly referred to colposcopy (direct COLP). At 24 months, hrHPV testing, LBC and VIA/VILI were conducted for combined screening.In rural sites, 1,949 hrHPV-positive women were analyzed. A total of 852, 218 and 480 women were randomly assigned to direct COLP, LBC and VIA/VILI. At baseline, colposcopy referral rates of LBC or VIA/VILI triage could be reduced by 70%-80%. LBC (n=3 and n=7) or VIA/VILI (n=8 and n=26) could significantly decrease the number of colposcopies needed to detect one cervical intraepithelial neoplasia (CIN) 2 or worse and CIN3+ compared with direct COLP (n=14 and n=23). For the 24-month cumulative detection rate of CIN2+, VIA/VILI triage was 0.50-fold compared with LBC triage and 0.46-fold with the direct COLP. When stratified by age, baseline LBC triage+ performed best (P<0.001), peaking among women aged 35-44 years (Ptrend=0.002). In urban sites, 1,728 women were hrHPV genotyping test positive. A total of 408, 571 and 568 women were randomly assigned to direct COLP for HPV16/18+, direct COLP for other hrHPV subtypes+, and LBC triage for other hrHPV subtypes+. LBC (n=12 and n=31) significantly decreased the number of colposcopies needed to detect one CIN2+ and CIN3+ compared with direct COLP (n=14 and n=44). HPV16/18+ increased the 24-month cumulative detection rate of CIN2+ (17.89%, P<0.001).LBC triage for hrHPV-positive women in rural settings and direct COLP for HPV16/18+ women and LBC triage for other hrHPV subtype+ women in urban settings might be feasible strategies.Copyright ©2022 Chinese Journal of Cancer Research. All rights reserved.

基金：
This study was funded by National Health Commission (formerly Health and Family Planning Commission) of China (No. 201502004); CAMS Innovation Fund for Medical Sciences (CIFMS) (No. 2021-I2M-1-004) and the Non-profit Central Research Institute Fund of Chinese Academy of Medical Sciences (No. 2019PT320010 and No. 2018PT32025).
语种：
外文
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中科院(CAS)分区：
出版当年[2022]版：
大类 | 3 区 医学
小类 | 3 区 肿瘤学
最新[2023]版：
大类 | 2 区 医学
小类 | 3 区 肿瘤学
JCR分区：
出版当年[2022]版：
Q2 ONCOLOGY
最新[2023]版：
Q1 ONCOLOGY

影响因子： 最新[2023版] 最新五年平均 出版当年[2022版] 出版当年五年平均 出版前一年[2021版] 出版后一年[2023版]

第一作者：
第一作者机构： [1]Department of Gynecology and Obstetrics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing 100730, China. [2]National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
通讯作者：
通讯机构： [1]Department of Gynecology and Obstetrics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing 100730, China. [22]School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100005, China. [*1]School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 9 Dongdan Santiao, Dongcheng District, Beijing 100730, China [*2]Peking Union Medical College Hospital, Chinese Academy of Medical Sciences/Peking Union Medical College, No. 9 Dongdan Santiao, Dongcheng District, Beijing 100730, China.
推荐引用方式(GB/T 7714)：
Dang Le,Kong Linghua,Zhao Yuqian,et al.Evaluation of triage strategies for high-risk human papillomavirus-positive women in cervical cancer screening: A multicenter randomized controlled trial in different resource settings in China[J].CHINESE JOURNAL OF CANCER RESEARCH.2022,34(5):496-+.doi:10.21147/j.issn.1000-9604.2022.05.09.
APA：
Dang Le,Kong Linghua,Zhao Yuqian,Dai Yi,Ma Li...&Lang Jinghe.(2022).Evaluation of triage strategies for high-risk human papillomavirus-positive women in cervical cancer screening: A multicenter randomized controlled trial in different resource settings in China.CHINESE JOURNAL OF CANCER RESEARCH,34,(5)
MLA：
Dang Le,et al."Evaluation of triage strategies for high-risk human papillomavirus-positive women in cervical cancer screening: A multicenter randomized controlled trial in different resource settings in China".CHINESE JOURNAL OF CANCER RESEARCH 34..5(2022):496-+

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