title: Can the careHPV test performed in mobile units replace cytology for screening in rural and remote areas?
abstract: BACKGROUND
  Human papillomavirus (HPV) DNA testing can be crucial for women who have limited access to traditional screening. The current study compared the results obtained through HPV DNA testing with those obtained through cytology-based screening.
  
  
  METHODS
  A total of 3068 women aged 18 to 85 years were enrolled in an opportunistic cervical cancer screening program developed by the Barretos Cancer Hospital and performed by a team of health professionals working within a mobile unit from March to December 2012, followed by statistical analyses. For each patient, 2 different cervical samples were collected and preserved in a careHPV assay and SurePath medium, respectively.
  
  
  RESULTS
  High-risk HPV (hr-HPV) DNA was detected in 10.0% of women, with the majority (86.7%) demonstrating no abnormal Papanicolaou test results. The following cytological samples were found to be hr-HPV positive: 8.2% of the normal samples; 39.4% of the samples with atypical squamous/glandular cells of undetermined significance; 38.5% of the samples with atypical squamous/glandular cells of undetermined significance, cannot exclude high-grade lesion; 55.3% of the samples with low-grade squamous intraepithelial lesions; and 100% of the samples with high-grade squamous intraepithelial lesions. Colposcopy examinations were performed among 33.4% of the women with positive results on at least 1 of the tests (HPV DNA positive and/or cytology with atypical squamous/glandular cells of undetermined significance, cannot exclude high-grade lesion or high-grade squamous intraepithelial lesions), and 59.5% of these women underwent biopsies. Among these samples, 18.2% were confirmed as cervical intraepithelial neoplasia.
  
  
  CONCLUSIONS
  The careHPV test was demonstrated to be a feasible alternative to primary screening in low-resource settings accessed through the use of mobile units. Cancer Cytopathol 2016;124:581-8. © 2016 American Cancer Society.
authors.affiliation: Institute of Education and Research and Molecular Oncology Center, Barretos Cancer Hospital, Pio XII Foundation, Barretos, São Paulo, Brazil.
authors.forename: Adriana T
authors.initials: AT
authors.lastname: Lorenzi
authors.affiliation: Institute of Education and Research and Molecular Oncology Center, Department of Researcher Support, Barretos Cancer Hospital, Pio XII Foundation, Barretos, São Paulo, Brazil.
authors.forename: José Humberto T
authors.initials: JH
authors.lastname: Fregnani
authors.affiliation: Institute of Education and Research and Molecular Oncology Center, Department of Prevention, Barretos Cancer Hospital, Pio XII Foundation, Barretos, São Paulo, Brazil.
authors.forename: Júlio César
authors.initials: JC
authors.lastname: Possati-Resende
authors.affiliation: Institute of Education and Research and Molecular Oncology Center, Department of Prevention, Barretos Cancer Hospital, Pio XII Foundation, Barretos, São Paulo, Brazil.
authors.forename: Márcio
authors.initials: M
authors.lastname: Antoniazzi
authors.affiliation: Institute of Education and Research and Molecular Oncology Center, Department of Pathology, Barretos Cancer Hospital, Pio XII Foundation, Barretos, São Paulo, Brazil.
authors.forename: Cristovam
authors.initials: C
authors.lastname: Scapulatempo-Neto
authors.affiliation: Medicity Research Laboratory and Department of Oral Pathology, Institute of Dentistry, Faculty of Medicine, University of Turku, Turku, Finland.|Department of Pathology, Turku University Central Hospital, Turku, Finland.
authors.forename: Stina
authors.initials: S
authors.lastname: Syrjänen
authors.affiliation: Faculty of Medical Sciences of Santa Casa of São Paulo, São Paulo, Brazil.|Department of Radiology and Oncology, Faculty of Medicine, Universidade de São Paulo, São Paulo, Brazil.
authors.forename: Luisa L
authors.initials: LL
authors.lastname: Villa
authors.affiliation: Institute of Education and Research and Molecular Oncology Center, Barretos Cancer Hospital, Pio XII Foundation, Barretos, São Paulo, Brazil.|Laboratory of Medical Investigation 14, Faculty of Medicine, Universidade de São Paulo, São Paulo, Brazil.|Life and Health Sciences Research Institute, School of Health Sciences, University of Minho, Braga, Portugal.|Life and Health Sciences Research Institute/3Bs-PT Government Associate Laboratory, Braga, Portugal.
authors.forename: Adhemar
authors.initials: A
authors.lastname: Longatto-Filho
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004279:DNA, Viral / Q000235:genetics; D005260:Female; D005500:Follow-Up Studies; D061809:Human Papillomavirus DNA Tests / Q000706:statistics & numerical data*; D006801:Humans; D008403:Mass Screening; D008875:Middle Aged; D008952:Mobile Health Units / Q000706:statistics & numerical data*; D060787:Neoplasm Grading; D065006:Papanicolaou Test; D027383:Papillomaviridae / Q000235:genetics; D030361:Papillomavirus Infections / Q000175:diagnosis* / Q000821:virology; D011379:Prognosis; D065310:Squamous Intraepithelial Lesions of the Cervix / Q000175:diagnosis* / Q000821:virology; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000821:virology; D014626:Vaginal Smears; D055815:Young Adult; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis* / Q000821:virology
chemical_list: D004279:DNA, Viral
keywords: Papanicolaou test; cancer screening; cervical cancer; colposcopy; human papillomavirus (HPV) DNA tests