Role of human papillomavirus testing in reducing the number of surgical treatments for precancerous cervical lesions.
OBJECTIVE
To determine whether the addition of the Hybrid Capture II (HC II) test (Digene Corp., Gaithersburg, MD, USA) to cytological, colposcopical and histological results could reduce the number of surgical treatment procedures for precancerous cervical lesions.


METHODS
Surgical treatment of precancerous cervical lesions was performed in 181 women. Priorly, the women were tested for high-risk human papillomavirus (HPV). Sensitivity, specificity, positive and negative predictive value were calculated to assess the performance characteristics of HC II in the detection of cervical intraepithelial neoplasia grade 2 or worse (CIN 2+) and grade 3 or worse (CIN 3+).


RESULTS
Eighty (44.2%) women had a histological result < CIN 2; 117 (64.6%) women had < CIN 3. Fifty-three (29.3%) women with < CIN 2 tested HPV negative; 69 (38.1%) women with < CIN 3 tested HPV negative (p < 0.05). The sensitivity of HC II for detecting CIN 2+ and CIN 3+ was 76.2% and 87.5%, respectively.


CONCLUSIONS
A high proportion of women were overtreated probably due to cytological and histological overestimations. HPV testing would reduce the number of unnecessary surgical treatments and should be used as an additional screening tool.
Vrtacnik-Bokal
E
E
Department of Obstetrics and Gynecology, University Medical Centre Ljubljana, Slovenia.
Rakar
S
S
Jancar
N
N
Mozina
A
A
Poljak
M
M
D000328:Adult; D003944:Diagnostic Techniques, Obstetrical and Gynecological; D005260:Female; D013509:Gynecologic Surgical Procedures; D006801:Humans; D027383:Papillomaviridae; D030361:Papillomavirus Infections / Q000150:complications / Q000175:diagnosis*; D011230:Precancerous Conditions / Q000175:diagnosis / Q000601:surgery*; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000601:surgery*; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis / Q000601:surgery*