title: History of high-risk HPV and Pap test results in a large cohort of patients with invasive cervical carcinoma: experience from the largest women's hospital in China.
abstract: BACKGROUND
  Current cervical cancer screening guidelines recommend screening with a Papanicolaou (Pap) test or by cotesting (Pap and human papillomavirus [HPV]). Given the importance of high-risk HPV (hrHPV) infection in the development of cervical cancer, some studies are now suggesting the use of primary hrHPV testing as a possible screening modality. To gain further insight into the role of both Pap testing and hrHPV testing, the authors examined prior screening results in a population of Chinese patients with invasive cervical carcinoma.
  
  
  METHODS
  Cases with a histologic diagnosis of invasive cervical carcinoma were retrieved from the Obstetrics and Gynecology Hospital of Fudan University from January 2011 to October 2014. Prior hrHPV testing and Pap test results within 3 years before the cancer diagnosis were recorded.
  
  
  RESULTS
  Of 3714 patients with invasive cervical carcinoma, over a 46-month period, 525 had prior hrHPV testing using Hybrid Capture 2 within 3 years and 238 patients had Pap cytology testing within 1 year before the histological diagnosis. Within the 1-year period before diagnosis, the overall hrHPV-negative rate was 15.5% (74 of 477 patients) and the Pap-negative rate was also 15.5% (37 of 238 patients). Only 9 of 231 patients with both hrHPV testing and Pap testing (3.9%) had a double-negative result. Compared with squamous cell carcinoma, adenocarcinoma has significantly higher rates of prior negative results with both hrHPV and Pap cytology.
  
  
  CONCLUSIONS
  The results of the current study demonstrated prior results of hrHPV testing and Pap cytology in a population of women in China who had not undergone intensive prior screening. Both hrHPV testing and Pap cytology were found to have similar negative rates in this population and, not surprisingly, there were fewer women who had negative testing results using both testing modalities.
authors.affiliation: Department of Pathology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China.
authors.forename: Xiang
authors.initials: X
authors.lastname: Tao
authors.affiliation: Department of Pathology, Magee-Womens Hospital of UPMC, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
authors.forename: Christopher C
authors.initials: CC
authors.lastname: Griffith
authors.affiliation: Department of Pathology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China.
authors.forename: Xiangrong
authors.initials: X
authors.lastname: Zhou
authors.affiliation: Department of Pathology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China.
authors.forename: Zhiheng
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Department of Pathology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China.
authors.forename: Yabin
authors.initials: Y
authors.lastname: Yan
authors.affiliation: Department of Pathology, Ohio State University Wexner Medical Center, Columbus, Ohio.
authors.forename: Zaibo
authors.initials: Z
authors.lastname: Li
authors.affiliation: Department of Pathology, Magee-Womens Hospital of UPMC, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
authors.forename: Chengquan
authors.initials: C
authors.lastname: Zhao
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D002681:China / Q000453:epidemiology; D015331:Cohort Studies; D016208:Databases, Factual; D055088:Early Detection of Cancer / Q000379:methods*; D005260:Female; D006782:Hospitals, Special; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology; D065006:Papanicolaou Test / Q000379:methods; D027383:Papillomaviridae / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology; D012189:Retrospective Studies; D018570:Risk Assessment; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology* / Q000473:pathology / Q000821:virology*; D014626:Vaginal Smears; D055815:Young Adult
keywords: China; Papanicolaou cytology; cervical cancer; human papillomavirus (HPV) test; screening