HPV testing is an efficient management choice for women with inadequate liquid-based cytology in cervical cancer screening.
This study compares colposcopy referrals of 2 management strategies: oncogenic human papillomavirus (HPV)-DNA testing (Hybrid Capture 2 assay, Qiagen, Germantown, MD) and repeat cytology. In the New Technology in Cervical Cancer Trial, 22,708 subjects were randomly assigned to undergo both HPV and liquid-based cytologic testing. Women aged 35 to 60 years old with unsatisfactory cytologic findings were directly referred for colposcopy if the HPV test result was positive, and were referred for repeat cytologic examination if the HPV test result was negative; women aged 25 to 35 years old were referred for repeat cytologic examination independent of HPV test results. A positive or a second unsatisfactory cytologic examination referred women for colposcopy. Five hundred sixty women had unsatisfactory cytologic findings. Colposcopy referral was not significant and slightly higher with HPV testing than repeat cytologic test (9.8% vs 6.8%, P = .11). When cytologic testing was repeated 36.8% were unavailable for follow-up and most of the colposcopies were performed in HPV-negative women. For unsatisfactory cytologic findings, HPV triage is a more logical and efficient management strategy than a repeat cytologic test.
AUSL Reggio Emilia, Epidemiology Unit, via Amendola 2, Reggio Emilia, 42122 Italy. paolo.giorgirossi@ausl.re.it
Paolo
P
Giorgi Rossi
Francesca
F
Carozzi
Guido
G
Collina
Massimo
M
Confortini
Paolo
P
Dalla Palma
Margherita
M
De Lillo
Annarosa
A
Del Mistro
Bruno
B
Ghiringhello
Anna
A
Gillio-Tos
Patrizia
P
Maioli
Antonella
A
Pellegrini
Maria Luisa
ML
Schiboni
Nereo
N
Segnan
Leandra M T
LM
Zaffina
Manuel
M
Zorzi
Guglielmo
G
Ronco
D000328:Adult; D003127:Colposcopy; D003581:Cytodiagnosis; D004279:DNA, Viral; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D027383:Papillomaviridae / Q000235:genetics* / Q000302:isolation & purification; D030361:Papillomavirus Infections / Q000175:diagnosis* / Q000473:pathology; D014218:Triage; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis* / Q000473:pathology / Q000821:virology; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000517:prevention & control; D014626:Vaginal Smears
D004279:DNA, Viral