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Human papillomavirus testing 2007–2012: C o‐testing and triage utilization and impact on subsequent clinical management
Author(s) -
Cuzick Jack,
Myers Orrin,
Hunt William C.,
Saslow Debbie,
Castle Philip E.,
Kinney Walter,
Waxman Alan,
Robertson Michael,
Wheeler Cosette M.
Publication year - 2014
Publication title -
international journal of cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.475
H-Index - 234
eISSN - 1097-0215
pISSN - 0020-7136
DOI - 10.1002/ijc.29337
Subject(s) - medicine , cytology , triage , human papillomavirus , gynecology , population , colposcopy , obstetrics , cancer , cervical cancer , emergency medicine , pathology , environmental health
In the United States, high‐risk human papillomavirus (HPV) testing is recommended for women with atypical squamous cells of unknown significance (ASC‐US) cytology, and co‐testing with cytology and HPV is a recommended option for screening women aged ≥30 years. No population‐based data are available to examine utilization of HPV testing in the United States. Using the New Mexico HPV Pap Registry data resource, we describe population trends (2007–2012) in utilization and positivity rates for HPV testing as a routine co‐testing screening procedure and for triage of ASC‐US and other cytologic outcomes. For women aged 30–65 years co‐testing increased from 5.2% in 2007 to 19.1% in 2012 ( p < 0.001). Overall 82% of women with ASC‐US cytology who did not receive co‐testing also had an HPV test. HPV positivity was age and cytology result dependent but did not show time trends. For women with negative cytology, 64% received an additional screening test within 3 years if no co‐test was done or if it was positive, but this was reduced to 47% with a negative co‐test. Reflex HPV testing for ASC‐US cytology is well established and occurs in most women. Evidence for reflex testing is also observed following other abnormal cytology outcomes. Co‐testing in women aged 30–65 years has more than tripled from 2007 to 2012, but was still only used in 19.1% of women aged 30–65 years attending for screening in 2012. Women receiving co‐testing had longer repeat screening intervals, but rescreening within 3 years is still very common even with co‐testing.