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High‐risk HPV platforms and test of cure: should specific HPV platforms more suited to screening in a ‘test of cure’ scenario be recommended?
Author(s) -
Innamaa A.,
Dudding N.,
Ellis K.,
Crossley J.,
Smith J. H.,
Tidy J. A.,
Palmer J. E.
Publication year - 2015
Publication title -
cytopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.512
H-Index - 48
eISSN - 1365-2303
pISSN - 0956-5507
DOI - 10.1111/cyt.12223
Subject(s) - medicine , colposcopy , cervical intraepithelial neoplasia , cervical screening , cytology , human papillomavirus , retrospective cohort study , obstetrics , gynecology , oncology , cervical cancer , pathology , cancer
Objective When the Sheffield screening laboratory changed the high‐risk human papillomavirus (hr HPV ) platforms from hybrid capture 2 ® ( HC 2; Digene Ltd) and to cobas 4800 ® (Roche) an unexpected and substantial increase in the number of cytology‐negative/hr HPV ‐positive test‐of‐cure (ToC) samples after large loop excision of the transformation zone ( LLETZ ) was noted. We explore the potential reasons for these increased rates and discuss the implications this may have on the English NHS cervical screening programme ( CSP ). Methods A retrospective cohort study with interval analysis between June 2007 and June 2012. Results ToC was performed on 1530 women with HC 2 and 396 with cobas 4800: 95.1% and 92.4% of women had negative cytology at ToC in the HC 2 and cobas4800 testing period, respectively. Of these 13.9% and 27.8% tested positive for hr HPV in the HC 2 and cobas 4800 group, respectively ( P = <0.0001). No clinically significant increase in the number of cases of cervical intraepithelial neolpasia ( CIN ) was detected by the cobas4800 test in spite of doubling the number of cytology‐negative/hr HPV ‐positive ToC samples. Conclusions As far as we are aware, this is the first study reporting potential differences between different HPV platforms currently available in the English programme. The immediate impact of this increase in rates of hr HPV detection with cobas4800 is an increased number of colposcopy referrals to our service. The NHSCSP needs to assess whether this increase is acceptable and, if not, whether specific HPV platforms more suited to screening in a ToC scenario should be recommended.