Triage by HPV-DNA testing: is it useful in women with persistent minor smear abnormalities?
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.


CONCLUSIONS
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.
Pisal
Narendra
N
Department of Women's Health, Whittington Hospital, London, UK. pisal@dr.com
Sindos
Michael
M
Chow
Carl
C
Singer
Albert
A
D000328:Adult; D003127:Colposcopy; D003430:Cross-Sectional Studies; D015344:DNA Probes, HPV; D004279:DNA, Viral / Q000032:analysis*; D005188:False Negative Reactions; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D008875:Middle Aged; D027383:Papillomaviridae / Q000235:genetics*; D030361:Papillomavirus Infections / Q000150:complications / Q000175:diagnosis; D011247:Pregnancy; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014218:Triage; D014412:Tumor Virus Infections / Q000150:complications / Q000175:diagnosis; D002577:Uterine Cervical Diseases / Q000175:diagnosis / Q000821:virology*; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000821:virology*; D014626:Vaginal Smears
D015344:DNA Probes, HPV; D004279:DNA, Viral