Evaluation of primary cervical cancer screening with an oncogenic human papillomavirus DNA test and cervical cytologic findings among women who attended family planning clinics in the United States.
OBJECTIVE
Our goal was to evaluate the performance of screening with (1) Papanicolaou and human papillomavirus (HPV) DNA testing and (2) Papanicolaou testing with reflex HPV testing of atypical squamous cells of undetermined significance for detecting cervical intraepithelial neoplasia grade 3 or more in clinics that serve low-income women in the United States.


METHODS
There were 4799 women who were recruited primarily from Planned Parenthood clinics and who were screened with liquid-based Papanicolaou testing and HPV DNA testing and referred for biopsy based on a positive test result for oncogenic HPV DNA or a Papanicolaou test that showed atypical squamous cells of undetermined significance or more.


RESULTS
Among 931 women who were 30-50 years of age, the sensitivity of reflex HPV testing was 53.8% (range, 38.2%-72.3%). The sensitivity of HPV DNA and Papanicolaou testing was 91% (range, 74.6%-100%). The specificity of reflex HPV testing was 95.1% (range, 93.8%-96.3%). Generally, the specificity of HPV DNA and Papanicolaou testing was low.


CONCLUSIONS
Among US women who are >or=30 years old, HPV DNA and Papanicolaou testing is a reasonable cervical cancer screening strategy.
Baseman
Janet G
JG
Department of Epidemiology, University of Washington, Seattle, WA, USA. jbaseman@u.washington.edu
Kulasingam
Shalini L
SL
Harris
Tiffany G
TG
Hughes
James P
JP
Kiviat
Nancy B
NB
Mao
Constance
C
Koutsky
Laura A
LA
D000293:Adolescent; D000328:Adult; D000554:Ambulatory Care Facilities; D001707:Biopsy, Needle; D002584:Cervix Uteri / Q000473:pathology / Q000821:virology*; D015344:DNA Probes, HPV; D004279:DNA, Viral / Q000302:isolation & purification; D005260:Female; D006801:Humans; D008403:Mass Screening; D008875:Middle Aged; D009367:Neoplasm Staging; D065006:Papanicolaou Test; D030361:Papillomavirus Infections / Q000150:complications / Q000473:pathology*; D014481:United States; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000821:virology; D014626:Vaginal Smears; D002578:Uterine Cervical Dysplasia / Q000473:pathology / Q000821:virology
D015344:DNA Probes, HPV; D004279:DNA, Viral