Application of domestic HPV hybrid capture test for cervical cancer screening in rural areas of China

OBJECTIVE: As we all know, human papillomavirus test is an effective method to detect cervical cancer. In recent years, we have developed several screening tests that were rapid, simple and affordable. This provides hope for the application of HPV detection test to women in China. Our study is to analyze the detection rate of precancerous lesions due to uterine cervix and cervical cancer using HPV hybrid capture (DH2) and 16/18 type detection test. METHODS: Women aged 35-64 from 7 counties in Xinmi received cervical cancer screening with DH2 test. Colposcope was conducted on DH2 test-positive women, and pathology-confirmed biopsies were done for final diagnosis. Surgery was necessary for women getting pathological results above CIN2 (CIN2+). HPV16/18 types detection test was also conducted on DH2 test-positive women in order to know the detection rate of precancerous lesions of uterine cervix and cervical cancer when HPV16/18 testing as a triage test. RESULTS: The overall HPV positive rate was 12.23%(1 512/12 358). The positive rate in women over 50 years old was found to be higher than that in women below 50 years old, reached 13.40%(749/5 588) and 11.27%(763/6 770), odds ratio was 1.22(1.09-1.36). There was statistical significance of differences in HPV prevalence between populations in different age groups(χ²=12.98, P<0.001). The detection number(rate) of CIN2+ and CIN3+ were 87(0.72%) and 50(0.41%), respectively. It reached the highest rate in Xinmi over the latest years. The positive rate of women who were screened with HPV16/18 types detection test was 2.66%(319/11 981). HPV16/18 was performed as a triage testing that could detect 62 cases of CIN2+ (0.52%) and 37 cases of CIN3+ (0.31%), and could detect 73.81%(62/84) CIN2+ and 77.08%(37/48) CIN3+ from all cases. CONCLUSIONS: The detection rate of precancerous lesions of uterine cervix and cervical cancer was high with DH2 test. We can use DN2 test as one of primary cervical cancer screening methods. Although HPV16/18 detection testing as a triage test decreased the colposcopy referral, it failed to detect part of the CIN2+ cases. As a result, for the undetected CIN2+ cases, the HPV genotyping is needed for future analysis.