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Helps with triage for colposcopic referral for LSIL cytology

-- Jeff Muise

Wednesday, June 23, 2010 (Last Updated: 06/24/2010)

WEDNESDAY, June 23 (HealthDay News) -- Human papillomavirus (HPV) and Pap test results can be used together in some cases to triage patients for further evaluation for cervical cancer with colposcopy, according to research published in the July issue of Obstetrics & Gynecology.

Philip E. Castle, Ph.D., of the National Cancer Institute in Bethesda, Md., and colleagues reviewed the HPV testing, cytology, and diagnostic results of cervical cancer screenings for nearly a million women aged 30 and older during 2003 to 2008. The women had been screened using Pap tests and DNA tests for 13 high-risk HPV genotypes. The potential to triage women to colposcopy using HPV testing and cytology together was assessed.

The researchers found that cervical cancer was most often found in the women with high-grade squamous intraepithelial lesions (HSIL), or atypical glandular cells cytology observed in Pap tests. Women who had a negative HPV test with atypical squamous cells that cannot exclude HSIL (ASC-H) cytology had a lower but still significant risk of cervical intraepithelial neoplasia grade 2 (CIN2), or the more serious CIN2+, compared to HPV-positive women with ASC-H cytology. Among women with a negative HPV test and low-grade squamous intraepithelial lesions (LSIL) there was a 4.0 percent risk of CIN2+, while among women 50 and older, there was only a 0.5 percent risk of CIN2+.

"Human papillomavirus testing may be useful for triage for colposcopic referral for LSIL cytology in older women but not for ASC-H cytology at any age," the authors write.

One study author reported financial ties to Gen-Probe, which makes the Aptima HPV test, as well as to Roche and Merck.

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Specialties Hematology & Oncology

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