title: High-risk HPV testing in women 30 years or older with negative Papanicolaou tests: initial clinical experience with 18-month follow-up.
abstract: Cervical screening with combined cytology and high-risk human papillomavirus (HR-HPV) detection has been approved for women 30 years or older. We investigated the clinical use of cotesting for women with negative Papanicolaou tests. Follow-up cytology, HR-HPV test, and biopsy findings were identified during an 18-month period. In 1 year, 2,719 cotests from 2,686 women were identified; 146 were positive for HR-HPV. Among women with positive HR-HPV testing, 120 had follow-up, including 70 with repeated cotesting, and 3 had high-grade dysplasia identified (2.5% of women with follow-up). In 1,334 women with initial double-negative cotest results who had repeated cytologic testing within 18 months, 2 high-grade dysplasias were found (0.1%). The vast majority of cotest results are double-negative. Among tests that show HR-HPV positivity, the prevalence of underlying high-grade dysplasia is low. About half of all women who undergo cotesting receive follow-up that is not in accord with published guidelines.
authors.affiliation: Department of Pathology, The Methodist Hospital, 6565 Fannin, Houston, TX 77030, USA.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Thrall
authors.forename: Donna K
authors.initials: DK
authors.lastname: Russell
authors.forename: Michael S
authors.initials: MS
authors.lastname: Facik
authors.forename: Jorge L
authors.initials: JL
authors.lastname: Yao
authors.forename: JulieAnn N
authors.initials: JN
authors.lastname: Warner
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Bonfiglio
authors.forename: Ellen J
authors.initials: EJ
authors.lastname: Giampoli
mesh_terms: D000328:Adult; D002584:Cervix Uteri / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D019983:Guideline Adherence; D006801:Humans; D065006:Papanicolaou Test; D030361:Papillomavirus Infections / Q000175:diagnosis*; D012306:Risk; D014626:Vaginal Smears; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis / Q000821:virology