Browsing by Author "Aslam, Shagufta"

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    A Pooled Analysis to Compare the Clinical Characteristics of Human Papillomavirus-positive and -Negative Cervical Precancers
    (2020) Castle, Philip E.; Pierz, Amanda J.; Adcock, Rachael; Aslam, Shagufta; Basu, Partha S.; Belinson, Jerome L.; Cuzick, Jack; El-Zein, Mariam; Ferreccio, Catterina; Firnhaber, Cynthia; Franco, Eduardo L.; Gravitt, Patti E.; Isidean, Sandra D.; Lin, John; Mahmud, Salaheddin M.; Monsonego, Joseph; Muwonge, Richard; Ratnam, Samuel; Safaeian, Mahboobeh; Schiffman, Mark; Smith, Jennifer S.; Swarts, Avril; Wright, Thomas C.; Van De Wyngard, Vanessa; Xi, Long Fu
    Given that high-risk human papillomavirus (HPV) is the necessary cause of virtually all cervical cancer, the clinical meaning of HPV-negative cervical precancer is unknown. We, therefore, conducted a literature search in Ovid MEDLINE, PubMed Central, and Google Scholar to identify English-language studies in which (i) HPV-negative and -positive, histologically confirmed cervical intraepithelial neoplasia grade 2 or more severe diagnoses (CIN2+) were detected and (ii) summarized statistics or deidentified individual data were available to summarize proportions of biomarkers indicating risk of cancer. Nineteen studies including 3,089 (91.0%) HPV-positive and 307 (9.0%) HPV-negative CIN2+ were analyzed. HPV-positive CIN2+ (vs. HPV-negative CIN2+) was more likely to test positive for biomarkers linked to cancer risk: a study diagnosis of CIN3+ (vs. CIN2; 18 studies; 0.56 vs. 0.24; P < 0.001) preceding high-grade squamous intraepithelial lesion cytology (15 studies; 0.54 vs. 0.10; P < 0.001); and high-grade colposcopic impression (13 studies; 0.30 vs. 0.18; P = 0.03). HPV-negative CIN2+ was more likely to test positive for low-risk HPV genotypes than HPV-positive CIN2+ (P < 0.001). HPV-negative CIN2+ appears to have lower cancer risk than HPV-positive CIN2+. Clinical studies of human high-risk HPV testing for screening to prevent cervical cancer may refer samples of HPV test-negative women for disease ascertainment to correct verification bias in the estimates of clinical performance. However, verification bias adjustment of the clinical performance of HPV testing may overcorrect/underestimate its clinical performance to detect truly precancerous abnormalities.