Human papillomavirus testing and reporting rates: practices of participants in the College of American Pathologists Interlaboratory Comparison Program in Gynecologic Cytology in 2006.
BACKGROUND
Oncogenic, high-risk human papillomavirus (HR-HPV) testing is used to evaluate women who are older than 20 years with atypical squamous cells of undetermined significance (ASC-US) and in conjunction with a screening Papanicolaou test in women older than 30 years.


OBJECTIVE
To evaluate the 2006 laboratory practice data from laboratories incorporating human papillomavirus (HPV) testing with the Papanicolaou test.


METHODS
To use the College of American Pathologists (CAP) Supplemental Questionnaire Survey for 2006 to determine laboratory practices of participants in the CAP Interlaboratory Comparison Program in Cervicovaginal Cytology.


RESULTS
A total of 679 laboratories responded to the questionnaire. Most (73%) refer HPV testing to reference laboratories. Nine percent perform HPV testing in cytology. Forty-five percent offer low-risk HPV (LR-HPV) testing. The most common reflex is ASC-US, although HR-HPV is also offered with low-grade squamous intraepithelial lesion (LSIL), high-grade squamous intraepithelial lesion (HSIL), or any other Papanicolaou test result. Digene Hybrid Capture II is the most common method. Human papilloma virus median test volumes are 55 monthly. Frequency distributions of HPV test volumes are significantly different from those found in 2003. Laboratories performing in-house testing reported significantly higher monthly HPV volumes (P < .001). Median rates for HR-HPV positivity are 36.6% for ASC-US, 50.0% for atypical squamous cells, cannot exclude HSIL (ASC-H), and 4% for women 30 years of age and older in conjunction with a screening Papanicolaou test.


CONCLUSIONS
Reference HPV testing remains the most common pattern. The most common reflex indication is for ASC-US, but HPV testing is modified locally to include a variety of scenarios. LR-HPV testing is commonly offered despite its lack of clinical significance. These data form a baseline for ongoing monitoring of HPV testing practice trends.
Moriarty
Ann T
AT
Department of Pathology, AmeriPath Indiana, Indianapolis, Indiana 46219-1739, USA. amoriarty@ameripath.com
Schwartz
Mary R
MR
Eversole
Galen
G
Means
Marilee
M
Clayton
Amy
A
Souers
Rhona
R
Fatheree
Lisa
L
Tench
William D
WD
Henry
Michael
M
Wilbur
David C
DC
D000328:Adult; D002584:Cervix Uteri / Q000473:pathology; D019411:Clinical Laboratory Techniques / Q000592:standards / Q000706:statistics & numerical data / Q000639:trends; D005260:Female; D006801:Humans; D065006:Papanicolaou Test; D027383:Papillomaviridae / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000175:diagnosis*; D010336:Pathology / Q000379:methods / Q000706:statistics & numerical data / Q000639:trends; D011364:Professional Practice / Q000706:statistics & numerical data / Q000639:trends; D018570:Risk Assessment; D012955:Societies, Medical; D014481:United States; D014621:Vagina / Q000473:pathology; D014626:Vaginal Smears / Q000706:statistics & numerical data / Q000639:trends