Extended HPV typing as an efficient alternative within HPV-based screening programs
Menée au Mexique auprès de 5 856 femmes âgées de 25 à 65 ans et incluses dans un programme public de dépistage du cancer du col utérin, cette étude évalue l'intérêt d'élargir le nombre de types de papillomavirus humains recherchés pour détecter précocement une néoplasie intraépithéliale de grade 3
Extended high-risk human papilloma virus (hrHPV) typing emerges as a potential alternative for detecting cervical intraepithelial neoplasia 3 (CIN3), without additional triage tests. We evaluate the extended hrHPV typing as an alternative to improve CIN3 detection within an HPV-based screening program. Between January 2017 and August 2018, 5856 women aged 25–65 years were screened as part of a public cervical cancer screening program of the Tlalpan Sanitary Jurisdiction in Mexico City. HPV testing was performed by BD Onclarity™, which individually detects hrHPV types 16, 18, 31, 45, 51, and 52, and pools of types 33/58, 56/59/66, and 35/39/68. Specific hrHPV types within these pools were further identified using the Atila AmpFire platform. All HPV-positive women (n = 691) were referred to colposcopy evaluation for diagnostic confirmation. Of these, 561 women completed both colposcopy and histological confirmation, representing our analytical sample. HPV-16 alone had a sensitivity of 43.0% and specificity of 85.4% for CIN3 detection. Sequentially adding HPV-18/33/31/39 increased sensitivity to 100% for CIN3 detection, although with lower specificity (54.5%). The proportion of HPV-16/18/33/31/39 positive women was 47.0%, with a CIN3 PPV 5.3%. Extended genotyping with HPV-16/18/33/31/39 achieved 100% sensitivity for CIN3 detection, but a moderate specificity. This strategy aligns with the international recommendation for colposcopy referral in women with a PPV of CIN3 larger than 4.0%.
International Journal of Cancer , article en libre accès, 2026