The role of HPV testing in patients with possible high-grade cervical cytology.
OBJECTIVE
To assess the role of human papillomavirus (HPV) testing for high-risk types in an Australian population with the equivalent cytological result of atypical squamous cells of undetermined significance - possible high-grade (ASC-H).


METHODS
A retrospective review was conducted of all patients referred with a 'possible high-grade squamous abnormality' Pap-smear result who underwent HPV testing for 13 high-risk types, colposcopy and directed biopsy, and any subsequent treatment.


RESULTS
The study included 100 patients. Overall, 79% of patients had a positive test for high-risk HPV DNA types. Histopathology was available for 98 patients and demonstrated that 47% of patients had confirmed high-grade dysplasia. HPV testing had a high sensitivity (98%), but low specificity (40%) for the detection of high grade dysplasia, and a negative predictive value of 95%.


CONCLUSIONS
The results of this study suggest that among patients with the equivalent of ASC-H cytology, a negative HPV DNA test for high-risk types is a good predictor of the absence of high-grade dysplasia. HPV testing in this patient population therefore has the potential to reduce the number women referred for colposcopy.
Rao
Archana
A
Department of Obstetrics and Gynaecology, Royal Prince Alfred Hospital, New South West, Australia.
Pather
Selvan
S
Dalrymple
Chris
C
Mackie
Adam
A
Deans
Rebecca
R
Carter
Jonathan
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D001315:Australia; D002584:Cervix Uteri / Q000473:pathology* / Q000821:virology*; D003127:Colposcopy; D004279:DNA, Viral / Q000032:analysis*; D005260:Female; D006801:Humans; D008875:Middle Aged; D065006:Papanicolaou Test; D027383:Papillomaviridae / Q000235:genetics*; D012680:Sensitivity and Specificity; D002578:Uterine Cervical Dysplasia / Q000473:pathology / Q000821:virology; D014626:Vaginal Smears
D004279:DNA, Viral