The utility of HPV DNA testing in triage of low-grade cytological abnormalities

Halfyard, Beth Banks (2008) The utility of HPV DNA testing in triage of low-grade cytological abnormalities. Masters thesis, Memorial University of Newfoundland.

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Abstract

This study evaluated the usefulness of human papillomavirus (HPV) DNA testing and repeat cytology in triage of women referred to colposcopy in St. John's, Newfoundland with atypical squamous cells of undetermined significance (ASCUS) or low-grade squamous intraepithelial lesion (LSIL) cytology. Data were collected on the initial Pap abnormality that prompted referral, HPV test, repeat Pap test, and histology if biopsies were ordered. Of 447 women, 97 with ASCUS and 145 with LSIL had results for all tests. For ASCUS, HPV testing was 100% sensitive for detection of underlying high-grade intraepithelial lesions (HSIL) while reducing referrals to 44.3%. There would have been significant reductions in referrals among women ≥30 years of age (74.3%) compared to younger women (27.4%). Nevertheless, in restricting HPV testing to women aged ≥30 years, 8/16 women with underlying HSIL would not have been referred to colposcopy. Repeat cytology was less sensitive (75%) for triaging all women. For LSIL, any method would have referred approximately 60% or more if a good sensitivity was achieved in any age group. For ASCUS, HPV triage appears to be more useful than repeat cytology. No useful triage strategy was identified for LSIL.

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