Research Article

A Study on the Utility of Screening Tests in Squamous Cell Carcinoma (SCC) and High-grade Intraepithelial Lesions (HSIL) of the Cervix: Evaluation of 447 Cases with Histopathological Diagnosis

Volume: 15 Number: 3 July 1, 2024
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A Study on the Utility of Screening Tests in Squamous Cell Carcinoma (SCC) and High-grade Intraepithelial Lesions (HSIL) of the Cervix: Evaluation of 447 Cases with Histopathological Diagnosis

Abstract

Introduction: Cervical cancer is one of the most common cancers in women. Precancerous lesions of the cervix can be detected with the combined use of smear testing and HPV (Human Papillomavirus) testing. International guidelines have been developed to indicate at what intervals and in which situations the tests should be performed. In this study, we examined the clinical utility of screening tests in patients with histopathologically diagnosed SCC (squamous cell carcinoma) and HSIL. Metods: Between January 2022 and June 2023, 447 patients aged 19-73 years (mean 37) with cervical biopsy results of SCC and HSIL were evaluated for the use of diagnostic tests (PAP smear and HPV test). Results: PAP smears were performed in 98.2% and HPV tests in 39.1% of all cases before histopathologic diagnosis. The most frequently detected high-risk HPV (hrHPV) was type 16. HPV testing significantly decreased with age. HPV testing was not performed in 74.2% of patients aged 51- 60 years and 80.9% of patients over 60 years. Conclusion: These cases the clinical utility and pathologic evaluation of the PAP smear were optimal. However, HPV testing practice was decreasing, especially with age. Cytologic evaluation may be misleading due to age-related hormonal withdrawal, difficulty in obtaining adequate smears, and atrophic changes. Our recommendation is to use HPV testing in all age groups, but especially in the population over 50 years of age, where cytologic difficulties may occur, HPV testing should be performed optimally until 65 years of age.

Keywords

Thanks

S.E. is a Clinical Fellow of the Takeda Science Foundation and greatly acknowledges educational support from them.

References

  1. 1. Perkins RB, Wentzensen N, Guido RS, Schiffman M. Cervical Cancer Screening. JAMA. 2023;330(6):547. doi:10.1001/jama.2023.13174
  2. 2. Kjær SK, Munk C, Junge J, Iftner T. Carcinogenic HPV prevalence and age-specific type distribution in 40,382 women with normal cervical cytology, ASCUS/LSIL, HSIL, or cervical cancer: What is the potential for prevention? Cancer Causes and Control. 2014;25(2). doi:10.1007/s10552-013-0320-z
  3. 3. Quinn BA, Deng X, Colton A, Bandyopadhyay D, Carter JS, Fields EC. Increasing age predicts poor cervical cancer prognosis with subsequent effect on treatment and overall survival. Brachytherapy. 2019;18(1). doi:10.1016/j.brachy.2018.08.016
  4. 4. Wentzensen N, Clarke MA. Cervical cancer screening - Past, present, and future. Cancer Epidemiology Biomarkers and Prevention. 2021;30(3). doi:10.1158/1055-9965.EPI-20-1628
  5. 5. Bamanikar S, Baravkar D, Chandanwale S, Dharwadkar A, Paranjape S. Study of cervical cytology and its correlation with clinical and histopathological findings. Clin Cancer Investig J. 2016;5(5). doi:10.4103/2278-0513.197869
  6. 6. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6). doi:10.3322/caac.21492
  7. 7. Sung H, Ferlay J, Siegel RL, et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021;71(3). doi:10.3322/caac.21660
  8. 8. Guan P, Howell-Jones R, Li N, et al. Human papillomavirus types in 115,789 HPV-positive women: A meta-analysis from cervical infection to cancer. Int J Cancer. 2012;131(10). doi:10.1002/ijc.27485

Details

Primary Language

English

Subjects

Pathology

Journal Section

Research Article

Authors

Publication Date

July 1, 2024

Submission Date

November 19, 2023

Acceptance Date

December 9, 2023

Published in Issue

Year 2024 Volume: 15 Number: 3

DOI

https://doi.org/10.31067/acusaglik.1392641

IZ

https://izlik.org/JA69TH72SC

Cite

RIS / Bibtex
EndNote
Ekemen S, Şahin D, Toprak S, Bilir E, Akbaş M, İnce Ü, Erkanlı S (July 1, 2024) A Study on the Utility of Screening Tests in Squamous Cell Carcinoma (SCC) and High-grade Intraepithelial Lesions (HSIL) of the Cervix: Evaluation of 447 Cases with Histopathological Diagnosis. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi 15 3 317–325.