title: Review of Cytology Practice at Thomas Jefferson University Hospital before and after High-Risk Human Papillomavirus Testing.
abstract: OBJECTIVE
  We performed a retrospective review of Papanicolaou (Pap) testing to assess whether the cytology practice in our institution was affected by the introduction of high-risk (HR) human papillomavirus (HPV) assays over time.
  
  
  METHODS
  Cytology, HPV and histopathology records were retrieved from our laboratory information system from 2003 to 2015. Records for Digene Hybrid Capture 2®, Hologic Cervista® and Roche Cobas® HPV assays were obtained. A 3-month follow-up for HPV detected cases was performed, and results were correlated with cytology and biopsies. A 1-year follow-up of HPV 16/18 and other HR HPV detected cases was also performed.
  
  
  RESULTS
  From 2008 to 2015, a noticeable decrease in Pap testing volume occurred, from 11,792 to 4,664, while the percentage of HPV testing increased from 19 to 59%. Similar HPV detection rates and follow-up results for both reflex and cotesting were observed in the 3 HPV assays.
  
  
  CONCLUSIONS
  The decrease in Pap testing was due to the lengthening of the test interval when cotesting results were negative. Practitioners adhering to guidelines accounts for increased molecular testing volume. A trend towards higher-grade cervical intraepithelial neoplasia in the follow-up of detected HPV 16/18 was noted. So far there has been no demand for HPV as a stand-alone test.
authors.affiliation: Cytopathology Laboratory, Department of Pathology, Anatomy and Cell Biology, Thomas Jefferson University, Philadelphia, Pa., USA.
authors.forename: Marluce
authors.initials: M
authors.lastname: Bibbo
authors.forename: Zi-Xuan
authors.initials: ZX
authors.lastname: Wang
authors.forename: Krister
authors.initials: K
authors.lastname: Jones
authors.forename: Charalambos
authors.initials: C
authors.lastname: Solomides
authors.forename: Rossitza
authors.initials: R
authors.lastname: Draganova-Tacheva
authors.forename: Robert
authors.initials: R
authors.lastname: Stapp
mesh_terms: D005260:Female; D006785:Hospitals, University; D052162:Human papillomavirus 16 / Q000472:pathogenicity*; D052161:Human papillomavirus 18 / Q000472:pathogenicity*; D006801:Humans; D008403:Mass Screening / Q000379:methods; D065006:Papanicolaou Test / Q000379:methods; D030361:Papillomavirus Infections / Q000175:diagnosis* / Q000473:pathology* / Q000821:virology; D012189:Retrospective Studies; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000821:virology; D014626:Vaginal Smears / Q000379:methods