NDLI: A modified Latent Class Model assessment of human papillomavirus-based screening tests for cervical lesions in women with atypical glandular cells: a Gynecologic Oncology Group study

Content Provider	Springer Nature Link
Author	Carter, Randy L. Kang, Le Darcy, Kathleen M. Kauderer, James Liao, Shu Yuan Rodgers, William H. Walker, Joan L. Lankes, Heather A. Dunn, S. Terence Stanbridge, Eric J.
Copyright Year	2012
Abstract	In the absence of gold standard diagnoses, we estimate age-specific false-positive and false-negative prediction rates of HPV-, cytology-, and histology-based tests for significant cervical lesions (SCL) in US women with AGC-NOS Pap smear diagnoses.Modified Latent Class Model (LCM) analyses, with prevalence of SCL modeled as a function of age, were applied to GOG-0171 study data (n = 122). The accuracies of several HPV-based tests, including Hybrid Capture II high-risk HPV (HC2 H-HPV); carbonic anhydrase IX (CA-IX); and invasive histological diagnosis, were compared. 1-PPV and 1-NPV were written as functions of sensitivity, specificity, and prevalence to obtain age-specific false-positive and false-negative rates.The histology-based test was nearly perfect (sensitivity = 1.00, CI = 0.98–1.00; specificity = 0.99, CI = 0.96–1.00). Otherwise, HC2 H-HPV performed best (sensitivity = 1.00, CI = 1.00–1.00; specificity = 0.87, CI = 0.79–0.94). The false-positive detection rates (1-PPV) for HC2 H-HPV were high (>17 %) at each age, while those of the histological diagnoses were low (<5 % at ages ≤60 and <17 % overall ages). False-negative prediction rates (1-NPV) for HC2 H-HPV were <0.11 % at each age and were uniformly lower than those of other tests, including the histology-based test (<0.25 %). CA-IX together with HC2 H-HPV did not improve performance.Women with negative HC2 H-HPV can safely forego invasive treatment (i.e., cone or LEEP biopsy, hysterectomy) in favor of observational follow-up. Additional biomarkers must be found for use in combination with HC2 H-HPV to reduce false-positive rates. This novel application of a modified LCM exemplifies methods for potential use in future cancer screening studies when gold standard diagnoses are not available.
Starting Page	2013
Ending Page	2021
Page Count	9
File Format	PDF
ISSN	09575243
Journal	Cancer Causes & Control
Volume Number	23
Issue Number	12
e-ISSN	15737225
Language	English
Publisher	Springer Netherlands
Publisher Date	2012-10-17
Publisher Place	Dordrecht
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Human papillomavirus Carbonic anhydrase IX Atypical glandular cells GOG HPV Biomedicine general Epidemiology Cancer Research Oncology Public Health Hematology
Content Type	Text
Resource Type	Article
Subject	Cancer Research Oncology

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