The agreement between cervical abnormalities identified by cytology and detection of high-risk types of human papillomavirus.
OBJECTIVE
Human papillomavirus (HPV) is causally associated with cervical cancer. Using the Digene Hybrid Capture 2 high-risk HPV test (HC2), we investigated the prevalence of high-risk HPV in cervical specimens, and compared results with those of Papanicolaou (Pap) smears taken concurrently.


METHODS
Cervical specimens were obtained from women attending hospitals / community health centres in the Western Cape province of South Africa. They were participating in a case-control study of the association of hormonal contraceptives and invasive cervical cancer.


RESULTS
Of 1 491 women tested, 254 (17%) were HPV DNA positive. The age-specific prevalence of HPV was 36/97 (37.1%) in those aged < 30 years, 78/369 (21.1%) in those aged 30 - 39 years, 78/603 (12.9%) in those aged 40 - 49 years and 62/422 (14.7%) in those aged 50 - 59 years. In women with normal cytology the prevalence of HPV was 10.9% (138/1 264); in those with abnormal squamous cells of unknown significance (AS-CUS) it was 30.8% (36/117); in those with low-grade squamous intraepithelial lesions (LSIL) it was 63.2% (36/57), and in those with high-grade squamous intraepithelial lesions (HSIL) it was 83% (44/53). The odds ratio between HPV and HSIL in women aged 40 - 59 years was 57.1 (confidence interval 22.4 - 170.7).


CONCLUSIONS
HC2 detected a high prevalence of HPV (17%) in this population. Most women with HSIL (83%) were positive, indicating that HPV testing of AS-CUS women may aid in management. When costs decrease, HC2 could be introduced as an adjunct to Pap smears in identifying women at risk for high-grade cervical disease and could be useful in the maintenance of cervical health in those who remain Pap smear negative.
Allan
Bruce R
BR
Institute of Infectious Disease and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, South Africa.
Marais
Dianne J
DJ
Denny
Lynette
L
Hoffman
Margaret
M
Shapiro
Samuel
S
Williamson
Anna-Lise
AL
D000328:Adult; D052685:Alphapapillomavirus / Q000145:classification* / Q000302:isolation & purification; D016022:Case-Control Studies; D003218:Condylomata Acuminata / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008875:Middle Aged; D065006:Papanicolaou Test; D015203:Reproducibility of Results; D012306:Risk; D014626:Vaginal Smears