The new face of cytology in HPV screening and immunization era
Monday, December 3, 2018
Scientific Session
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SS 02
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9:45 AM
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11:15 AM
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The new face of cytology in HPV screening and immunization era
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Auditorium II
Effective cervical cancer screening is driven by the prevalence of disease and the sensitivity of the screening test. With high quality screening, the easiest to diagnose disease tends to be eliminated and this fact combined with the lowering of prevalence, makes screening system performance degrade as sensitivity remains fixed. HPV vaccination, which has well demonstrated to decrease vaccine type HPV prevalence will decrease prevalence and therefore will have a dramatic impact on screening systems.
These mathematical certainties demand that one re-evaluate the performance of cytology and its place in screening. Can we augment cervical cytology samples with tests that improve the performance of the sample? This is especially important as we transition through an era of lowered prevalence in established screening systems with growing vaccinated populations and potentially smaller and harder to sample lesions? Does molecular analysis of the cytologic sample correct the predicted issues of sensitivity? Does morphology survive in a utilitarian fashion once HPV molecular determinants are known? And if so, will traditional morphology be used or will the preferred sample have biomarker enhanced morphology? With the potential for automation of molecular methods, will be the cost of maintaining morphology in algorithms be worth it?
Using data from organized screening systems, such as Sweden, with historically excellent cytology, Dr. Dillner will explore the impact of age and prevalence on cytology perfromance in non-vaccinated vs. vaccinated populations. Given the recent expansion of HPV primary screening in many countries, does co-testing add substantially to the performance of the screening system and if so why are so few countries choosing to do co-testing? Dr Wentzsen wil provide us with insights on this important question. In countires like Italy where the proof of HPV primary screening was so well demonstrated, the question of how to best triage a positive HPV test is critical. Dr Ronco provides data on cytology triage and compares this to other methods including genotyping. Dr Stoler will then extend this discussion on optimal triage using p16 biomarker enhanced cytology, examining recent clinical trial data comparing cytology to p16 dual-stain in terms of both sensitivity and specificity.
9:45 AM
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SS 02-01
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Cytology by age - strength and weaknesses in vaccinated and non-vaccinated women
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J.
Joakim
DILLNER
10:03 AM
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SS 02-02
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Screening - Cotesting versus HPV alone: is cytology of added value?
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N.
Nicolas
WENTZENSEN
10:21 AM
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SS 02-03
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Performance of cyto-triage of HPV-positive women versus other strategies
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G.
Guglielmo
RONCO
10:39 AM
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SS 02-04
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Cytology revisited: role of p16
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M.
Mark
STOLER
10:57 AM
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SS 02-05
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Discussion
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