International Journal of Cancer 2022

Redesign of a rapid, low-cost HPV typing assay to support risk-based cervical screening and management.

Desai KT, Adepiti CA, Schiffman M, Egemen D, Gage JC, Wentzensen N, de Sanjosé S, Burk RD, Ajenifuja KO
Accelerated cervical cancer control will require widespread HPV vaccination and screening. For screening, sensitive HPV testing with an option of self-collection is increasingly desirable. HPV typing predicts risk of precancer/cancer, which could be useful in management, but most current typing assays are expensive and/or complicated. An existing 15-type isothermal amplification assay (AmpFire, Atila Biosystems, US) was redesigned as a 13-type assay (ScreenFire) for public health use. The redesigned assay groups HPV types into four channels with differential cervical cancer risk: i) HPV16, ii) HPV18/45, iii) HPV31/33/35/52/58, iv) HPV39/51/56/59/68. Since the assay will be most useful in resource-limited settings, we chose a stratified random sample of 453 provider-collected samples from a population-based screening study in rural Nigeria that had been initially tested with MY09-MY11-based PCR with oligonucleotide hybridization genotyping. Frozen residual specimens were masked and retested at Atila Biosystems. Agreement on positivity between ScreenFire and prior PCR testing was very channels. When we simulated intended use, i.e., a hierarchical result in order of clinical importance of the type groups (HPV16> 18/45> 31/33/35/52/58> 39/51/56/59/68), the weighted kappa for ScreenFire versus PCR was 0.90 (95% CI: 0.86-0.93). The ScreenFire assay is mobile, relatively simple, rapid (results within 20-60 minutes), and agrees well with reference testing particularly for the HPV types of greatest carcinogenic risk. If confirmed, ScreenFire or similar isothermal amplification assays could be useful as part of risk-based screening and management.This article is protected by copyright. All rights reserved.