title: Significance of HPV tests on women with cervical smears showing ASCUS.
abstract: BACKGROUND
  The relationship between the human papillomavirus (HPV) tests and the cytological findings was evaluated.
  
  
  METHODS
  Totally, 161 women participating in the organized cytological screening in the County of Uppsala and showing atypical squamous cells of uncertain significance (ASCUS) in their cervical smears were identified during 2002 and 2003. Those women were invited for a repeated examination about 3 months later. At that occasion, a smear sample was collected and used for cytological examination and a concomitant HPV test. Oncogenic HPV was identified by polymerase chain reaction and HPV deoxyribonucleoside acid (DNA) sequence analysis in 50 cases and by Hybrid Capture II in 111 cases.
  
  
  RESULTS
  Women with an ASCUS diagnosis showed a normal cytology and a negative HPV test in 30% of the cases, abnormal cytology and a positive HPV test in 32% of the cases; in 26% of the women, the HPV test was positive, whereas cytology was normal; and in 11% of the women, the HPV test was negative, whereas cytology was abnormal (ASCUS or more).
  
  
  CONCLUSIONS
  The results show that HPV tests identify a larger group of women at risk to develop cervical cancer in comparison with cytological examination. As the HPV tests have a higher sensitivity than the cytological screening, it is suggested that an HPV test in conjunction with a diagnosis of ASCUS can be employed to more efficiently select women, to whom further follow up is recommended.
authors.affiliation: Department of Women's and Childrens Health, Akademiska sjukhuset, S-751 85 Uppsala, Sweden. ingrid.wikstrom@kbh.uu.se
authors.forename: Anna
authors.initials: A
authors.lastname: de Lang
authors.forename: Ingrid
authors.initials: I
authors.lastname: Wikström
authors.forename: Erik
authors.initials: E
authors.lastname: Wilander
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D015344:DNA Probes, HPV; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D006291:Health Policy; D006801:Humans; D008875:Middle Aged; D027383:Papillomaviridae / Q000302:isolation & purification*; D016133:Polymerase Chain Reaction; D011237:Predictive Value of Tests; D013548:Sweden / Q000453:epidemiology; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology / Q000821:virology*; D014626:Vaginal Smears / Q000592:standards*; D002578:Uterine Cervical Dysplasia / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology / Q000821:virology*
chemical_list: D015344:DNA Probes, HPV; D004279:DNA, Viral