{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,19]],"date-time":"2025-09-19T09:25:43Z","timestamp":1758273943362,"version":"3.40.5"},"reference-count":14,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2022,8,22]],"date-time":"2022-08-22T00:00:00Z","timestamp":1661126400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Cytology performed directly on hrHPV\u2010positive self\u2010samples (reflex cytology) is feasible and for women with abnormal cytology, an additional cytology test at the general practitioner could be omitted. The aim of this study is to assess the added value of digital imaging (ThinPrep\u00ae Imaging System) on the clinical utility of reflex cytology by reducing screening error.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>A secondary analysis of a prospective cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>One of five Dutch screening laboratories.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>Women tested hrHPV\u2010positive on self\u2010samples between December 2018 and August 2019.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Self\u2010samples were used for reflex cytology with and without digital imaging. The follow\u2010up data (cytological and histological results within 1\u2009year of follow\u2010up) were obtained through the Dutch Pathology Registry (PALGA).<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Test performance of the reflex cytology was determined by comparing it with physician\u2010collected follow\u2010up results.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The sensitivity for detecting abnormal cells by reflex cytology on self\u2010samples increased significantly from 26.3% (42\/160; 95% confidence interval [CI] 19.6\u201333.8) without digital imaging to 35.4% (56\/158; 95% CI 28\u201343.4) with digital imaging (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05) without compromising specificity. Importantly, 41.7% of women with \u2265CIN2 (35\/84) and 45.6% with \u2265CIN3 (26\/57) were detected by reflex cytology with digital imaging on hrHPV\u2010positive self\u2010samples.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Digital imaging is of added value to reflex cytology on hrHPV\u2010positive self\u2010samples with a 9% increase in sensitivity. If reflex cytology on self\u2010samples analysed with digital imaging had been implemented in the screening programme, 35.4% of the hrHPV\u2010positive women with abnormal cytology on additional physician\u2010collected samples could have been referred directly for colposcopy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.17272","type":"journal-article","created":{"date-parts":[[2022,8,3]],"date-time":"2022-08-03T16:29:54Z","timestamp":1659544194000},"page":"184-191","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["The added value of digital imaging to reflex cytology for triage of high\u2010risk human papillomavirus positive self\u2010sampled material in cervical cancer screening: A prospective cohort study"],"prefix":"10.1111","volume":"130","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7270-1445","authenticated-orcid":false,"given":"Danique","family":"Wiersma","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology Radboud University Medical Centre  Nijmegen The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne","family":"Vinke","sequence":"additional","affiliation":[{"name":"Department of Pathology Radboud University Medical Centre  Nijmegen The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Albert G.","family":"Siebers","sequence":"additional","affiliation":[{"name":"Department of Pathology Radboud University Medical Centre  Nijmegen The Netherlands"},{"name":"PALGA, The Nationwide Network and Registry of Histo\u2010 and Cytopathology  Houten The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Willem J. G.","family":"Melchers","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology Radboud University Medical Centre  Nijmegen The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruud L. M.","family":"Bekkers","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Catharina Hospital  Eindhoven The Netherlands"},{"name":"GROW, School for Oncology &amp; Developmental Biology Maastricht University Medical Centre  Maastricht The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diede L.","family":"Loopik","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Radboud University Medical Centre  Nijmegen The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,8,22]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.16352"},{"key":"e_1_2_14_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-019-1460-0"},{"key":"e_1_2_14_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.33320"},{"key":"e_1_2_14_5_1","doi-asserted-by":"publisher","DOI":"10.1080\/14737140.2016.1232166"},{"key":"e_1_2_14_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-019-39275-2"},{"key":"e_1_2_14_7_1","unstructured":"Erasmus Medical Centre PDPR.Landelijke Monitoring Bevolkingsonderzoek Baarmoederhalskanker (National Monitoring Cervical Cancer Screening). Monitor 2019."},{"key":"e_1_2_14_8_1","unstructured":"ThinPrep\u00aeImager duo imaging system operator\u2019s manual version 3.x.y software[cited 2020 November 4]. Available from:https:\/\/www.hologic.com\/sites\/default\/files\/package\u2010insert\/MAN\u201003133\u2010001_004_02.pdf"},{"key":"e_1_2_14_9_1","unstructured":"ThinPrep\u00aeReview scope manual+ operator\u2019s manual version 1.x.y software[cited 2020 November 4]. Available from:https:\/\/www.hologic.com\/sites\/default\/files\/package\u2010insert\/MAN\u201003695\u2010001_002_02.pdf"},{"issue":"1","key":"e_1_2_14_10_1","first-page":"19","article-title":"Pathology databanking and biobanking in the Netherlands, a central role for PALGA, the nationwide histopathology and cytopathology data network and archive","volume":"29","author":"Casparie M","year":"2007","journal-title":"Cell Oncol"},{"key":"e_1_2_14_11_1","doi-asserted-by":"publisher","DOI":"10.1309\/AGB1MJ9H5N43MEGX"},{"key":"e_1_2_14_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.20721"},{"key":"e_1_2_14_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/dc.20627"},{"key":"e_1_2_14_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/dc.21199"},{"key":"e_1_2_14_15_1","doi-asserted-by":"publisher","DOI":"10.1159\/000325959"}],"container-title":["BJOG: An International Journal of Obstetrics &amp; Gynaecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1471-0528.17272","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/1471-0528.17272","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1471-0528.17272","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,20]],"date-time":"2023-08-20T13:33:07Z","timestamp":1692538387000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/1471-0528.17272"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,22]]},"references-count":14,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2023,1]]}},"alternative-id":["10.1111\/1471-0528.17272"],"URL":"https:\/\/doi.org\/10.1111\/1471-0528.17272","archive":["Portico"],"relation":{},"ISSN":["1470-0328","1471-0528"],"issn-type":[{"type":"print","value":"1470-0328"},{"type":"electronic","value":"1471-0528"}],"subject":[],"published":{"date-parts":[[2022,8,22]]},"assertion":[{"value":"2021-05-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-04-12","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-08-22","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}