Cervical cancer screening by high risk HPV testing in routine practice: results at one year recall of high risk HPV-positive and cytology-negative women.
OBJECTIVE
Cervical cancer screening by human papillomavirus (HPV) testing requires the use of additional triage and follow-up analyses. We evaluated women's compliance with and the performance of this strategy in a routine setting.


METHODS
Five cervical service screening programmes in North-East Italy.


METHODS
Eligible women aged 25-64 invited for a new screening episode underwent HPV testing for high risk types (hrHPV by Hybrid Capture 2) and cytology triage. Women with positive HPV and cytology results were referred for colposcopy; women with positive HPV but negative cytology results were referred to 1-year repeat hrHPV testing.


RESULTS
Of 46,694 women screened by HPV testing up to December 2011, 3,211 (6.9%) tested hrHPV positive; 45% of these had a positive triage cytology. Those with negative cytology were invited for 1-yr repeat testing. Compliance with invitation was 61.6% at baseline and 85.3% at 1-yr repeat. Rate of persistent hrHPV positivity was 58% (830/1,435). Colposcopy performed in women with a positive hrHPV test at 1-yr repeat accounted for 36% of all colposcopies performed within the screening programmes. Cumulatively, a histological high-grade lesion was detected in 276 women (5.9‰ detection rate), 234 at baseline (85%), and 42 (15%) at 1-yr repeat.


CONCLUSIONS
Compliance with hrHPV-based screening programmes was high both at baseline and at 1-yr repeat. Compared with the randomized trials, a higher proportion of triage cytology was read as positive, and only a small number of high-grade lesions were detected among the group of hrHPV positive cytology negative women who repeated testing 1-yr after baseline.
Immunology and Molecular Oncology Unit, Veneto Oncology Institute IOV IRCCS, Padova, Italy.
Annarosa
A
Del Mistro
Helena
H
Frayle
Antonio
A
Ferro
Susanna
S
Callegaro
Annamaria
A
Del Sole
Anna
A
Stomeo
Emanuela
E
Cirillo
Chiara
C
Fedato
Silvana
S
Pagni
Luisa
L
Barzon
Manuel
M
Zorzi
D000328:Adult; D003127:Colposcopy / Q000379:methods; D055088:Early Detection of Cancer; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007558:Italy; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D027383:Papillomaviridae / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000175:diagnosis* / Q000821:virology; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000821:virology*; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis / Q000821:virology
HPV; follow-up; organized screening; triage