Human papillomavirus triage of patients with atypical squamous cells of undetermined significance on cervical Papanicolaou smear.
BACKGROUND
The recent development of affordable human papillomavirus (HPV) testing has prompted consideration of its use as adjuvant and primary screening for cervical dysplasia. This review focuses on the use of HPV testing in triage management of atypical squamous cells of undetermined significance (ASC-US) Pap smears.


METHODS
A Medline search was performed for articles relevant to HPV testing as a triage strategy for ASC-US Paps. Key references from other papers that were not included in the search were also reviewed. Findings from the major randomised trials were then summarised.


RESULTS
Reflex HPV testing with hybrid capture is at least as effective and potentially cheaper than repeat cytology for evaluation of an ASC-US Pap. It also avoids 50% of colposcopies that would normally be performed if immediate colposcopy were done for all ASC-US Paps, while retaining excellent negative predictive value.


CONCLUSIONS
Reflex HPV testing using liquid-based cytology is the preferred management strategy for triage of ASC-US Paps.
Kirby
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Division of Gynecologic Oncology, University of Alabama at Birmingham, OHB Room 538, 619 19th Street South, Birmingham, AL 35249-7333, USA.
Huh
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WK
Partridge
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D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000821:virology*; D003127:Colposcopy / Q000379:methods; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D006801:Humans; D008403:Mass Screening; D008875:Middle Aged; D065006:Papanicolaou Test; D027383:Papillomaviridae / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000150:complications / Q000175:diagnosis*; D016133:Polymerase Chain Reaction / Q000379:methods; D011379:Prognosis; D012680:Sensitivity and Specificity; D012846:Singapore; D014218:Triage; D002578:Uterine Cervical Dysplasia / Q000473:pathology / Q000821:virology*; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000821:virology*; D014626:Vaginal Smears
D004279:DNA, Viral