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Viral load, shortterm fluctuations in HPV prevalence and different HPV testing methods: implications for population-based screening

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Samenvatting van de aanvraag

The fact that high-risk human papillomavirus (hrHPV) infection is a necessary cause of cervical cancer offers possibilities to implement hrHPV testing as an adjunct to cervical cytology to improve the efficacy of cervical cancer screening programs. Still, several HPV testing methods have been developed and their clinical performance has not yet been mutually compared in longitudinal studies. Moreover, recent studies suggested that women with an increased viral load in their smears have an increased risk of high-grade cervical lesions, but this aspect has so far not been used to set criteria to be fulfilled by HPV testing methods for screening purposes. Finally, short-term fluctuations in HPV detectability during the menstrual cycle may either mask or overestimate a women's risk of high-grade cervical disease when HPV testing is performed at a single, random time point. It will be clear that all abovementioned issues need to be addressed before incorporation of an HPV test in cervical cancer screening programs ultimately can be envisaged. By combining the strengths of two centres with a long-lasting expertise in HPV testing and epidemiology we want to address the following questions: 1. What is the clinical performance of different HPV testing methods when applied to women with normal cytology? 2. What is the clinical performance of different HPV testing methods when applied to women with borderline and mild dyskaryosis? 3. Do fluctuations in HPV prevalence either or not at different anatomical sites of the cervix during the menstrual cycle have clinical consequences for the time a cervical scrape for HPV detection is taken? 4. Can assessment of viral load in women with normal cytology be used to increase the specificity of HPV testing approaches for lesions =CIN 3?

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Projectnummer:
22000147
Looptijd: 100%
Looptijd: 100 %
2003
2008
Onderdeel van programma:
Projectleider en penvoerder:
Verantwoordelijke organisatie:
Amsterdam UMC - locatie VUmc