Primary HPV cervical screening: Clinical audit of outcomes of women seen at a tertiary referral centre for colposcopy in Australia.

The Australian & New Zealand Journal of Obstetrics & Gynaecology
Felicia H X ChinJeffrey H J Tan

Abstract

Primary human papillomavirus (HPV) screening was introduced in Australia in December 2017. Outcomes for women after positive HPV in their cervical screening test (CST). A retrospective observational study of 4458 women seen at the Royal Women's Hospital Colposcopy Clinic from 1 January 2018 to 31 July 2020. HPV16/18 was positive (considered higher-risk CST) in 42.2% of women in the study, 16.6% with reflex possible with high-grade squamous intraepithelial lesions (pHSIL) or worse and 54.9% with normal cytology. There were 24.8% of women with positive HPV16/18 who had histological confirmed cervical intraepithelial neoplasia grade 2 or worse (CIN2+), 10.3% CIN2+ (including six cancers) among women with reflex negative cytology and 87.7% CIN2+ among women with reflex HSIL cytology. In women with positive HPV (not 16/18), CIN2+ was found in 60.2% with reflex pHSIL or worse cytology (higher risk) and 10.2% with reflex low-grade SIL (LSIL) or normal cytology (intermediate risk). Median waiting time to colposcopy with the intermediate-risk group went up to 181 days. Our colposcopists were able to achieve a positive predictive value (PPV) for CIN2+ of 69.9%, higher than 57.8% PPV in the National Cervical Screening Program (NCSP) 2020 ...Continue Reading

References

Aug 22, 2009·The Australian & New Zealand Journal of Obstetrics & Gynaecology·Alice HuangJeffrey Tan
Jan 22, 2010·The Lancet Oncology·Guglielmo RoncoUNKNOWN New Technologies for Cervical Cancer screening (NTCC) Working Group
Sep 29, 2011·British Journal of Cancer·M ArbynN Wentzensen
Feb 9, 2018·Clinical Cancer Research : an Official Journal of the American Association for Cancer Research·Megan A ClarkeRobert D Burk
Jun 7, 2019·The Medical Journal of Australia·Dorothy A MachalekAnnabelle Farnsworth
Aug 7, 2019·Public Health Research & Practice·Megan SmithMarion Saville
Apr 4, 2020·Journal of Lower Genital Tract Disease·Rebecca B PerkinsUNKNOWN 2019 ASCCP Risk-Based Management Consensus Guidelines Committee
Sep 12, 2020·The Australian & New Zealand Journal of Obstetrics & Gynaecology·Jeffrey H J TanC David H Wrede

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