Open AccessTriage by HPV‐DNA testing: is it useful in women with persistent minor smear abnormalities?
Author(s) -
Pisal Narendra,
Sindos Michael,
Chow Carl,
Singer Albert
Publication year - 2003
Publication title -
acta obstetricia et gynecologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.401
H-Index - 102
eISSN - 1600-0412
pISSN - 0001-6349
DOI - 10.1034/j.1600-0412.2003.00155.x
Subject(s) - medicine , colposcopy , triage , obstetrics , cervical cancer , squamous intraepithelial lesion , biopsy , gynecology , prospective cohort study , cervical intraepithelial neoplasia , cancer , emergency medicine
Background. 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. Methods. 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. Results. 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. Conclusion. 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.