Human papillomavirus oncogenic mRNA testing for cervical cancer screening: baseline and longitudinal results from the CLEAR study

Am J Clin Pathol. 2015 Sep;144(3):473-83. doi: 10.1309/AJCPHVD7MIP3FYVV.

Abstract

Objectives: This study determined the longitudinal clinical performance of a high-risk human papillomavirus (HR-HPV) E6/E7 RNA assay (Aptima HPV [AHPV]; Hologic, San Diego, CA) compared with an HR-HPV DNA assay (Hybrid Capture 2 [HC2]; Qiagen, Gaithersburg, MD) as an adjunctive method for cervical cancer screening.

Methods: Women 30 years or older with a negative result for intraepithelial lesions or malignancy cytology (n = 10,860) positive by AHPV and/or HC2 assays and randomly selected women negative by both assays were referred to colposcopy at baseline. Women without baseline cervical intraepithelial neoplasia (CIN) grade 2 or higher (CIN2+) continued into the 3-year follow-up.

Results: The specificity of AHPV for CIN2 or lower was significantly greater at 96.3% compared with HC2 specificity of 94.8% (P < .001). Estimated sensitivities and risks for detection of CIN2+ were similar between the two assays. After 3 years of follow-up, women negative by either human papillomavirus test had a very low risk of CIN2+ (<0.3%) compared with CIN2+ risk in women with positive AHPV results (6.3%) or positive HC2 results (5.1%).

Conclusions: These results support the use of AHPV as a safe and effective adjunctive cervical cancer screening method.

Keywords: Adjunct screening; Aptima HPV; Cervical cancer; Cervical intraepithelial neoplasia; E6/E7 mRNA.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Early Detection of Cancer* / methods
  • Female
  • Genetic Testing
  • Humans
  • Longitudinal Studies
  • Middle Aged
  • Molecular Diagnostic Techniques
  • Papillomaviridae / genetics*
  • Papillomaviridae / isolation & purification
  • Papillomavirus Infections / diagnosis*
  • Pregnancy
  • RNA, Messenger / genetics*
  • RNA, Viral / genetics
  • RNA, Viral / isolation & purification*
  • Uterine Cervical Dysplasia / diagnosis
  • Uterine Cervical Neoplasms / diagnosis*
  • Uterine Cervical Neoplasms / virology

Substances

  • RNA, Messenger
  • RNA, Viral