title: Influence of high risk HPV genotype on colposcopic performance: A large prospective study demonstrates improved detection of disease with ZedScan I, particularly in non-HPV 16 patients.
abstract: OBJECTIVE
  To assess the influence of high-risk Human Papilloma Virus (hrHPV) genotyping on the detection of high-grade disease (CIN2+) using colposcopic impression both with and without electrical impedance spectroscopy (ZedScan I) as an adjunct.
  
  
  METHODS
  A prospective cohort of women with a known hrHPV genotype referred to a single colposcopy service.
  
  
  RESULTS
  839 women underwent colposcopy and ZedScan I examination. 613 women were referred with abnormal cytology; 411 (67%) with low-grade dyskaryosis (67%) and 202 (33%) with high-grade dyskaryosis. 187 were referred with persistent hrHPV but negative cytology. 35 were attended for follow up and 4 for a clinical indication. 159 (19%) women were positive for HPV16 only; 54 (6%) with HPV18 only, 443 (53%) women were positive for hrHPV other types (HPV O). 183 (22%) were positive for multiple hrHPV genotypes. CIN2+ was present in 170 (84.2%) of high-grade and 69 (16.7%) of low-grade cytology referrals. Colposcopy was better at detecting HPV16 associated CIN2+ than that associated with HPV18 or HPV O (86.9% vs 79.7%, p=0.0191). ZedScan I increased the detection of CIN2+ from 85.6% to 96% irrespective of hrHPV genotype status (p<0.0001).
  
  
  CONCLUSIONS
  The use of an electrical impedance spectroscopic device (ZedScan I) increases detection of CIN2+ irrespective of hrHPV genotype.
authors.affiliation: Colposcopy Clinic, Jessop Hospital Wing, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK. Electronic address: madeleine.macdonald@sth.nhs.uk.
authors.forename: Madeleine C
authors.initials: MC
authors.lastname: Macdonald
authors.affiliation: Medical Physics, University of Sheffield, Sheffield, UK.
authors.forename: Brian H
authors.initials: BH
authors.lastname: Brown
authors.affiliation: Colposcopy Clinic, Jessop Hospital Wing, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
authors.forename: Rachel E
authors.initials: RE
authors.lastname: Lyon
authors.affiliation: Medical Physics, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
authors.forename: T Jamie
authors.initials: TJ
authors.lastname: Healey
authors.affiliation: Colposcopy Clinic, Jessop Hospital Wing, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
authors.forename: Julia E
authors.initials: JE
authors.lastname: Palmer
authors.affiliation: Colposcopy Clinic, Jessop Hospital Wing, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
authors.forename: John A
authors.initials: JA
authors.lastname: Tidy
mesh_terms: D000328:Adult; D000368:Aged; D003127:Colposcopy; D005260:Female; D005838:Genotype; D006801:Humans; D008403:Mass Screening; D008875:Middle Aged; D027383:Papillomaviridae / Q000235:genetics*; D030361:Papillomavirus Infections / Q000821:virology*; D011446:Prospective Studies; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000821:virology; D014626:Vaginal Smears; D055815:Young Adult; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis* / Q000821:virology
keywords: Electrical impedance spectroscopy; High-grade CIN; ZedScan; hrHPV genotype