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. 2021 Nov 26:13:8855-8863.
doi: 10.2147/CMAR.S335701. eCollection 2021.

Screening History in Vaginal Precancer and Cancer: A Retrospective Study of 2131 Cases in China

Lu Zhang  1 , Qing Wang  1 , Hongwei Zhang  1 , Yu Xie  1 , Long Sui  1 , Qing Cong  1
Affiliations

Screening History in Vaginal Precancer and Cancer: A Retrospective Study of 2131 Cases in China

Lu Zhang et al. Cancer Manag Res. .

Abstract

Purpose: To examine the screening history of vaginal intraepithelial neoplasia (VaIN) and vaginal cancer.

Patients and methods: We included women with histologically confirmed VaIN or vaginal cancer by colposcopy-directed biopsy between 1 January 2019 and 31 December 2019. The results of cytology, hrHPV, colposcopic examination and history of hysterectomy were retrospectively analysed.

Results: A total of 26,432 colposcopies were performed during the study period, among which 2131 women (1835 [86.1%] with VaIN 1; 268 [12.6%] with VaIN 2/3; and 28 [1.3%] with vaginal cancer) were retrospectively studied. hrHPV test positivity was significantly higher than that of cytology for VaIN 1 (84.4% vs 67.3%; P < 0.001) and VaIN 2/3 (92.0% vs 79.9%; P < 0.001) but not for vaginal cancer (84.6% vs 78.6%; P = 0.73). Additionally, the concordance rates for colposcopic impression were 79.5%, 54.5%, and 92.8% for VaIN1, VaIN2/3, and vaginal cancer, respectively. All 372 patients had a history of hysterectomy, and 81.0% (282/348) of indications were related to cervical precancer and cancer. Although cytology test positivity was significantly higher in patients with hysterectomy than in patients without hysterectomy (76.2% vs 67.5%; P < 0.001), cytology combined with hrHPV can help to detect more than 95% of VaIN and vaginal cancer cases in both groups (96.2% for patients with hysterectomy and 96.5% for patients without hysterectomy).

Conclusion: VaIN and vaginal cancer are not rare diseases. Although cytology was sensitive (67.5%-76.2%) for detecting vaginal lesions regardless of hysterectomy, cytology combined with hrHPV improves detection accuracy up to 95% in both groups.

Keywords: colposcopy; cytology; human papilloma virus; vaginal cancer; vaginal intraepithelial neoplasia.

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Conflict of interest statement

The authors declare that there is no conflict of interest regarding the publication of this paper.

Figures

Figure 1
Figure 1
The positivity of cytology, hrHPV and cotesting in VaIN and vaginal cancer.
Figure 2
Figure 2
Distribution of hrHPV in VaIN and vaginal cancer.
See this image and copyright information in PMC

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Grants and funding

No external funding from private or public organizations were received for the conduct of this study or the preparation of this manuscript.