{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T01:15:31Z","timestamp":1776215731723,"version":"3.50.1"},"reference-count":29,"publisher":"American Association for Cancer Research (AACR)","issue":"8","funder":[{"DOI":"10.13039\/501100003593","name":"CNPq","doi-asserted-by":"publisher","award":["573799\/2008-3"],"award-info":[{"award-number":["573799\/2008-3"]}],"id":[{"id":"10.13039\/501100003593","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001807","name":"FAPESP","doi-asserted-by":"publisher","award":["2008\/57889-1"],"award-info":[{"award-number":["2008\/57889-1"]}],"id":[{"id":"10.13039\/501100001807","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["aacrjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2019,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Every year there are approximately 16,000 new cases of cervical cancer in Brazil. Novel screening technologies may reduce this number by expanding the population coverage but also by improving the detection rate of precursor lesions. We aimed to evaluate human papillomaviruses (HPV)-DNA testing in the context of routine cervical cancer screening in the public health system of the city of S\u00e3o Paulo, Brazil. Women participating in the primary screening program were invited to enroll. Liquid-based cytology samples were collected and cytology and Hr-HPV DNA testing were performed in parallel. Cytologists were blind to HPV results. Women older than 24 years with a positive high-risk HPV test and\/or cytology class \u2265 ASC-US were referred to colposcopy. From December 2014 to December 2016, 16,102 women joined the study. High-risk human papillomavirus (HR HPV) DNA prevalence was 14.9%, whereas cytologic abnormalities were found in 7.2% of the women. Per protocol, 1,592 Hr-HPV+ women, in addition to 72 patients with cytologic classification &amp;gt; low-grade squamous intraepithelial lesion (LSIL) were referred. A total of 80 cervical intraepithelial neoplasia (CIN2+) cases were diagnosed, 79 were Hr-HPV DNA+ and 18 had normal cytology. Hr-HPV DNA detected a significant number of patients with premalignant lesions missed by cytology and all 16 CIN3+ cases were Hr-HPV DNA+. HPV genotyping may be useful in the management of Hr-HPV+ women, reducing the burden of colposcopic referral for those harboring genotypes with a weaker association to CIN3+. Use of HPV-DNA testing was shown to be feasible and advantageous over current cytologic screening in the public health system.<\/jats:p>","DOI":"10.1158\/1940-6207.capr-19-0076","type":"journal-article","created":{"date-parts":[[2019,6,12]],"date-time":"2019-06-12T20:54:05Z","timestamp":1560372845000},"page":"539-546","update-policy":"https:\/\/doi.org\/10.1158\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["High-Risk HPV Testing in Primary Screening for Cervical Cancer in the Public Health System, S\u00e3o Paulo, Brazil"],"prefix":"10.1158","volume":"12","author":[{"given":"Jos\u00e9 Eduardo","family":"Levi","sequence":"first","affiliation":[{"name":"1Instituto de Medicina Tropical da Universidade de S\u00e3o Paulo, Virology Laboratory (LIM 52), S\u00e3o Paulo, Brazil."}]},{"given":"Toni Ricardo","family":"Martins","sequence":"additional","affiliation":[{"name":"1Instituto de Medicina Tropical da Universidade de S\u00e3o Paulo, Virology Laboratory (LIM 52), S\u00e3o Paulo, Brazil."},{"name":"2Faculdade de Medicina da Universidade de S\u00e3o Paulo, S\u00e3o Paulo, Brazil."}]},{"given":"Adhemar","family":"Longatto-Filho","sequence":"additional","affiliation":[{"name":"2Faculdade de Medicina da Universidade de S\u00e3o Paulo, S\u00e3o Paulo, Brazil."},{"name":"3ICVS\/3B's - PT Government Associate Laboratory, Braga\/Guimar\u00e3es, Portugal."},{"name":"4Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal."},{"name":"5Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, S\u00e3o Paulo, Brazil."}]},{"given":"Diane Dede","family":"Cohen","sequence":"additional","affiliation":[{"name":"6Funda\u00e7\u00e3o Oncocentro de S\u00e3o Paulo, S\u00e3o Paulo, Brazil."}]},{"given":"Lise","family":"Cury","sequence":"additional","affiliation":[{"name":"6Funda\u00e7\u00e3o Oncocentro de S\u00e3o Paulo, S\u00e3o Paulo, Brazil."}]},{"given":"Luiz Mario","family":"Fuza","sequence":"additional","affiliation":[{"name":"1Instituto de Medicina Tropical da Universidade de S\u00e3o Paulo, Virology Laboratory (LIM 52), S\u00e3o Paulo, Brazil."},{"name":"6Funda\u00e7\u00e3o Oncocentro de S\u00e3o Paulo, S\u00e3o Paulo, Brazil."}]},{"given":"Luisa L.","family":"Villa","sequence":"additional","affiliation":[{"name":"2Faculdade de Medicina da Universidade de S\u00e3o Paulo, S\u00e3o Paulo, Brazil."},{"name":"7Instituto do C\u00e2ncer do Estado de S\u00e3o Paulo, S\u00e3o Paulo, Brazil."}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7504-2115","authenticated-orcid":false,"given":"Jos\u00e9","family":"Eluf-Neto","sequence":"additional","affiliation":[{"name":"2Faculdade de Medicina da Universidade de S\u00e3o Paulo, S\u00e3o Paulo, Brazil."},{"name":"6Funda\u00e7\u00e3o Oncocentro de S\u00e3o Paulo, S\u00e3o Paulo, Brazil."}]}],"member":"1086","published-online":{"date-parts":[[2019,8,1]]},"reference":[{"key":"2026041420331965200_bib1","volume-title":"Cancer incidence in five continents","author":"Forman","year":"2013"},{"key":"2026041420331965200_bib2","article-title":"Estimativa 2018: incid\u00eancia de c\u00e2ncer no Brasil\/Instituto Nacional de C\u00e2ncer Jos\u00e9 Alencar Gomes da Silva\u2013Rio de Janeiro: INCA","year":"2017"},{"key":"2026041420331965200_bib3","doi-asserted-by":"crossref","first-page":"e0201262","DOI":"10.1371\/journal.pone.0201262","article-title":"Self-sampling coupled to the detection of HPV 16 and 18 E6 protein: a promising option for detection of cervical malignancies in remote areas","volume":"13","author":"Torres","year":"2018","journal-title":"PLoS One"},{"key":"2026041420331965200_bib4","doi-asserted-by":"crossref","first-page":"817","DOI":"10.1016\/j.cmi.2015.04.015","article-title":"Which high-risk HPV assays fulfil criteria for use in primary cervical cancer screening?","volume":"21","author":"Arbyn","year":"2015","journal-title":"Clin Microbiol Infect"},{"key":"2026041420331965200_bib5","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1016\/j.ygyno.2014.11.076","article-title":"Primary cervical cancer screening with human papillomavirus: end of study results from the ATHENA study using HPV as the first-line screening test","volume":"136","author":"Wright","year":"2015","journal-title":"Gynecol Oncol"},{"key":"2026041420331965200_bib6","doi-asserted-by":"crossref","first-page":"524","DOI":"10.1016\/S0140-6736(13)62218-7","article-title":"Efficacy of HPV-based screening for prevention of invasive cervical cancer: follow-up of four European randomised controlled trials","volume":"383","author":"Ronco","year":"2014","journal-title":"Lancet"},{"key":"2026041420331965200_bib7","doi-asserted-by":"crossref","first-page":"S69","DOI":"10.1016\/j.jcv.2015.11.035","article-title":"Implementation of HPV testing in Latin America","volume":"76","author":"Jeronimo","year":"2016","journal-title":"J Clin Virol"},{"key":"2026041420331965200_bib8","doi-asserted-by":"crossref","first-page":"1952","DOI":"10.1002\/ijc.31212","article-title":"Initial results of population based cervical cancer screening program using HPV testing in one million Turkish women","volume":"142","author":"Gultekin","year":"2018","journal-title":"Int J Cancer"},{"key":"2026041420331965200_bib9","article-title":"Coordena\u00e7\u00e3o de Preven\u00e7\u00e3o e Vigil\u00e2ncia. 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