Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Findings and Challenges Replacing the Traditional Uterine Cervical Cancer Diagnosis with Molecular Tools in the Private Gynecological Practice in Mexico

Version 1 : Received: 15 April 2024 / Approved: 16 April 2024 / Online: 16 April 2024 (08:41:43 CEST)

A peer-reviewed article of this Preprint also exists.

Castrillo-Diez, J.L.; Rivera-Santiago, C.; Ávila-Flores, S.M.; Barrera-Barrera, S.A.; Barrera-Saldaña, H.A. Findings and Challenges in Replacing Traditional Uterine Cervical Cancer Diagnosis with Molecular Tools in Private Gynecological Practice in Mexico. Viruses 2024, 16, 887. Castrillo-Diez, J.L.; Rivera-Santiago, C.; Ávila-Flores, S.M.; Barrera-Barrera, S.A.; Barrera-Saldaña, H.A. Findings and Challenges in Replacing Traditional Uterine Cervical Cancer Diagnosis with Molecular Tools in Private Gynecological Practice in Mexico. Viruses 2024, 16, 887.

Abstract

We have been encouraging practicing gynecologists to adopt molecular diagnostics tests, PCR, and cancer biomarkers, as an alternative enabled by these platforms to traditional Papanicolaou and colposcopy tests, respectively. An aliquot of liquid-based cytology was used for the molecular test [high-risk HPV types, (HR HPV)], another for the PAP test and still one more for the p16/Ki67 dual stain cytology. A total of 4,499 laboratory samples were evaluated, and we found that 25.1% of low-grade samples and 47.9% of high-grade samples after PAP testing had a negative HR HPV-PCR result. In those cases, reported as Pap-negative, 22.1% got a positive HR HPV-PCR result. Dual staining with the p16/Ki67 biomarkers in samples was positive for HR HPV, and 31.7% were also positive for these markers. Of the PCR results positive for any of these high-risk HPV subtypes, n 68.3% we did not to find evidence for the presence of cancerous cells, highlighting the importance of performing dual staining with p16/Ki67 after PCR, to avoid unnecessary colposcopies. Encountered challenges are a deep-rooted social reluctance in Mexico to abandon traditional Pap smears and the opinion of many specialists, we still believe that colposcopy continues to be a preferred procedure over dual staining protocol.

Keywords

uterine cervical cancer screening; HPV genotyping; p16/Ki67 biomarkers; gynecology private practice

Subject

Public Health and Healthcare, Public Health and Health Services

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