Baseline human papillomavirus status of women with abnormal smears in cervical screening: a 5-year follow-up study in The Netherlands.
OBJECTIVE
To determine in a screening population the human papillomavirus (HPV) status in those with cytological abnormalities and to evaluate the presence of high-risk (HR) HPV with a minimum of 5-year follow up.


METHODS
Retrospective examination of HPV status on prospectively collected and cytologically screened cervical smears.


METHODS
Canisius-Wilhelmina Hospital in Nijmegen, The Netherlands.


METHODS
Three hundred and fifty-seven women aged 30-60 years, from the population screened.


METHODS
Three hundred and fifty-seven women with borderline or higher cytological abnormalities were retrospectively examined for HPV with DNA microarray typing. Follow up was through the nationwide Dutch Pathology database (PALGA).


METHODS
For the cytological abnormalities, the CISOE-A classification was used. HPV was scored as negative or positive. In case of positive HPV polymerase chain reaction, the HPV genotype was determined. The occurrence of cervical intraepithelial neoplasia lesions of grade 3 or higher was considered as endpoint for follow up.


RESULTS
The majority of the women with borderline cytology in this study were HPV negative (87%). Among the HPV-positive women in borderline cytology group, 74% had HR-HPV or probable high-risk types. The overall percentage of HR-HPV types increased with progressive cytological abnormalities. The cytological classifications of borderline dyskaryosis and moderate dyskaryosis contain all types of HPVs, e.g. low risk, HR and unknown risk. The samples with severe dyskaryosis or higher contain only HR types. The negative predictive value for HR-HPV typing in the group with borderline cytological abnormalities is more than 99%.


CONCLUSIONS
In cervical screening with an interval of 5 years, HPV can be reliably used as triage point in cases of borderline cytological abnormalities.
Prinsen
C F M
CF
Department of Pathology C66, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands.
Fles
R
R
Wijnen-Dubbers
C W
CW
de Valk
H A
HA
Klaassen
C H W
CH
Mravunac
M
M
Horrevorts
A M
AM
Thunnissen
F B J M
FB
D000328:Adult; D004279:DNA, Viral / Q000032:analysis; D004812:Epidemiologic Methods; D005260:Female; D052162:Human papillomavirus 16 / Q000235:genetics; D006801:Humans; D008403:Mass Screening; D008875:Middle Aged; D021141:Nucleic Acid Amplification Techniques; D030361:Papillomavirus Infections / Q000150:complications* / Q000473:pathology; D016133:Polymerase Chain Reaction; D012307:Risk Factors; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000821:virology*; D014626:Vaginal Smears; D002578:Uterine Cervical Dysplasia / Q000473:pathology / Q000821:virology*
D004279:DNA, Viral