title: Impact of age on the false negative rate of human papillomavirus DNA test in patients with atypical squamous cells of undetermined significance.
abstract: OBJECTIVE
  Human papillomavirus (HPV) test was incorporated into the triage of lesser abnormal cervical cytologies: atypical squamous cells of undetermined significance (ASCUS) or low-grade squamous intraepithelial lesion (LSIL). This study aimed to evaluate the impact of age on the efficacy of HPV testing in patients with lesser abnormal cervical cytologies.
  
  
  METHODS
  A total of 439 patients with ASCUS or LSIL were included. The association between age groups and the diagnostic performances of HPV test for high-grade cervical intraepithelial neoplasia (CIN2+) was evaluated.
  
  
  RESULTS
  Median age was 44 years (range, 17 to 75 years). ASCUS was more frequently observed in older patients while LSIL was more common in younger patients (P=0.002). CIN2+ was found in 11.3% (32/284) of the ASCUS patients and 12.9% (20/155) of patients with LSIL. Older patients with ASCUS showed lower HPV infection rates (P=0.025), but not LSIL (P=0.114). However, the prevalence of CIN2+ was similar between the age groups with ASCUS or LSIL. In patients with ASCUS, the false negative rate of HPV test for CIN2+ was 6.2%. The false negative rate of the HPV test became higher with increasing of the age after the age of 50 (P=0.034).
  
  
  CONCLUSIONS
  Our findings suggest that false negative rate of the HPV test for CIN2+ in ASCUS patients older than 50 years might become higher with increasing of the age. Negative HPV results in patients of the age >50 years with ASCUS should be carefully interpreted.
authors: Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea.
authors: Kyu-Hee
authors: KH
authors: Won
authors: Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea.
authors: Jae Yeon
authors: JY
authors: Lee
authors: Department of Obstetrics and Gynecology, Hallym University Dongtan Sacred Heart Hospital, Hwasung, Korea.
authors: Hye-Yon
authors: HY
authors: Cho
authors: Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Korea.
authors: Dong Hoon
authors: DH
authors: Suh
authors: Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Korea.
authors: Jae Hong
authors: JH
authors: No
authors: Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Korea.
authors: Yong-Beom
authors: YB
authors: Kim
keywords: Age; Atypical squamous cells of the cervix; Human papillomavirus DNA tests; Uterine cervical dysplasia