An evaluation of human papillomavirus testing as part of referral to colposcopy clinics.
OBJECTIVE
To determine the usefulness of human papillomavirus (HPV) testing as a triage method for predicting which women referred to a colposcopy clinic were most likely to have histologically confirmed cervical intraepithelial neoplasia (CIN).


METHODS
Papanicolaou tests, ViraPap tests for HPV infection, and colposcopically directed biopsies were performed concurrently on 482 women referred to a student health colposcopy clinic.


RESULTS
The results demonstrated that HPV positivity was associated with a greatly increased likelihood of histologic confirmation of CIN, especially among women with concurrent cytologic findings that were negative or showed only atypical squamous cells of undetermined significance.


CONCLUSIONS
Testing for HPV appears to have a role in the triage of students now being referred to our colposcopy clinic. A combination of HPV testing and repeated cytologic screening would provide reasonably sensitive screening for cervical neoplasia while limiting the use of colposcopic services, which are currently overburdened. The eventual usefulness of HPV testing will depend on the cost and availability of colposcopy services, the cost of Papanicolaou tests, the cost and accuracy of HPV tests, and the predictive value of HPV detection in the population being screened.
Cox
J T
JT
University of California, Student Health Service, Santa Barbara.
Schiffman
M H
MH
Winzelberg
A J
AJ
Patterson
J M
JM
D000328:Adult; D001706:Biopsy; D003127:Colposcopy; D003365:Costs and Cost Analysis; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D006801:Humans; D065006:Papanicolaou Test; D027383:Papillomaviridae / Q000302:isolation & purification*; D011237:Predictive Value of Tests; D012017:Referral and Consultation; D013333:Student Health Services / Q000191:economics; D014412:Tumor Virus Infections / Q000175:diagnosis*; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology; D014626:Vaginal Smears
D004279:DNA, Viral