Triage by HPV-DNA testing: is it useful in women with persistent minor smear abnormalities?

Acta Obstetricia Et Gynecologica Scandinavica
Narendra PisalAlbert Singer

Abstract

This study was carried out to evaluate the efficacy of HPV-DNA (Human Papilloma Virus) testing as a triage strategy for persistent borderline and mild cytological abnormalities. A prospective cross-sectional study involving 321 women registered between January and December 2001 with two smears showing borderline or mild dyskaryosis, taken 6 months apart. This study was undertaken in a colposcopy unit in a large district general hospital in central London. Three hundred and twenty-one women referred with persistent borderline and mild dyskaryosis were recruited in this study. HPV-DNA testing was positive in 194 women (60.4%). Histology of colposcopically directed biopsy showed CIN2/3 in 57 women (18%). Fifty-one of these 57 women were detected by HPV-DNA testing (sensitivity for high-grade disease 89.5%). Specificity for high-grade disease was 45.8%. Negative predictive value was 95.3%. Women with a positive HPV-DNA result had a 7.2 times higher risk of having a high-grade cervical cancer precursor lesion. Negative predictive value of HPV-DNA testing for high-grade cervical lesion is very high. Hence, it can be used as a triage strategy for persistent borderline changes and mild dyskaryosis.

References

Nov 1, 1988·British Journal of Obstetrics and Gynaecology·B S Bolger, B V Lewis
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May 28, 1994·BMJ : British Medical Journal·G FlannellyA A Templeton
Jan 17, 2002·Journal of the National Cancer Institute·Mark E ShermanUNKNOWN Atypical Squamous Cells of Undetermined Significance/Low-Grade Squamous Intraepithelial Lesion Triage Study Group
Apr 23, 2002·JAMA : the Journal of the American Medical Association·Thomas C WrightUNKNOWN ASCCP-Sponsored Consensus Conference

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Citations

Apr 9, 2010·BJOG : an International Journal of Obstetrics and Gynaecology·S CottonUNKNOWN Trial Of Management of Borderline and Other Low-grade Abnormal Smears Group
Feb 6, 2004·Acta Obstetricia Et Gynecologica Scandinavica·Andrea GuyotMay s Kyi
Apr 2, 2013·The Cochrane Database of Systematic Reviews·Marc ArbynWalter J Prendiville
Jun 15, 2007·International Journal of Cancer. Journal International Du Cancer·Matejka ReboljJ Dik F Habbema
Oct 19, 2004·Journal of Virological Methods·Andrea L Fuessel HawsStephen K Tyring

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