Human Papillomavirus testing for the management of low-grade cervical abnormalities in the UK--Influence of age and testing strategy.
BACKGROUND
The results of the UK pilot studies were encouraging with respect to the introduction of Human Papillomavirus (HPV) testing as a means to improve the management of low-grade cytological abnormalities. However, several important unresolved issues related to HPV triage remain, two of which are: what type of HPV test should be used and what age group should be targeted.


OBJECTIVE
To perform an evaluation of two commercial HPV detection tests and to correlate disease persistence and clearance with age and HPV status by the two tests.


METHODS
We performed an evaluation of two commercial HPV tests in a cross-sectional analysis of 322 cervical cytology specimens with low-grade abnormalities. A subset of these specimens were then examined longitudinally, in order to correlate disease persistence and clearance with age and HPV status by the two detection tests.


RESULTS
The two tests performed similarly with respect to the longitudinal identification/prediction of high-grade cervical disease. Age did not appear to be a factor in determining which cases went on to manifest high-grade disease within 3 years of a low-grade result (p=0.678).


CONCLUSIONS
This study weakens the case for age-adjusted HPV triage of low-grade cervical abnormalities.
Cuschieri
K S
KS
Specialist Virology Centre, Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh EH16 4SA, United Kingdom. Kate.Cuschieri@luht.scot.nhs.uk
Graham
C
C
Moore
C
C
Cubie
H A
HA
D000328:Adult; D002584:Cervix Uteri / Q000473:pathology* / Q000821:virology*; D003430:Cross-Sectional Studies; D003581:Cytodiagnosis; D018450:Disease Progression; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D027383:Papillomaviridae / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000175:diagnosis* / Q000821:virology; D011933:Reagent Kits, Diagnostic; D012680:Sensitivity and Specificity; D006113:United Kingdom; D002577:Uterine Cervical Diseases / Q000175:diagnosis* / Q000821:virology
D011933:Reagent Kits, Diagnostic