Comparison of human papillomavirus DNA testing and repeat Papanicolaou test in women with low-grade cervical cytologic abnormalities: a randomized trial

Lytwyn, Alice; Sellors, John W.; Mahony, James B.; Daya, Dean; Chapman, William; Ellis, Noella; Roth, Paula; Lorincz, Attila T.; Gafni, Amiran
September 2000
CMAJ: Canadian Medical Association Journal;9/19/2000, Vol. 163 Issue 6, p701
Academic Journal
Background: Results of cervical cytology screening showing atypical squamous cells of undetermined significance (ASCUS) or low-grade squamous intraepithelial lesions (LSIL) indicate risk for high-grade cervical intraepithelial neoplasia (CIN 2 or 3). In a community-based randomized trial we compared the test performance of human papillomavirus (HPV) DNA testing with that of 6-month repeat Papanicolaou (Pap) test in detecting histologically confirmed CIN 2 or 3.Methods: We randomly assigned 212 women aged 16-50 years with ASCUS or LSIL on cervical cytology screening to undergo either immediate HPV DNA testing or a repeat Pap test in 6 months. Cervical swabs for the HPV DNA testing and the Pap smears were obtained by their familiy physicians. We tested the swabs for oncogenic HPV using the Hybrid Capture II assay (Digene Corp., Beltsville, Md.). Community-based pathologists examined the Pap smears. All women were referred for colposcopy by their family physicians. Two gynecological pathologists assessed the histology findings. We calculated test performance in women who completed the trial using CIN 2 or 3 as the reference standard.Results: A total of 159 women completed the study. Compared with HPV DNA testing, which detected 87.5% (7/8) of the cases of CIN 2 or 3, repeat Pap smear showing high-grade intraepithelial neoplasia (HSIL) detected 11.1% (1/9) of cases (p = 0.004), and repeat Pap smear showing ASCUS, LSIL or HSIL detected 55.6% (5/9) (p = 0.16). Corresponding specificities were 50.6%, 95.2% (p = 0.002) and 55.6% (p = 0.61). Loss to follow-up was 17.1% in the HPV test group and 32.7% in the repeat Pap group (p = 0.009). Given the 7 cases of CIN 2 or 3 detected by HPV testing and the 5 cases detected by the repeat Pap smear, the incremental cost of HPV testing was calculated to be $3003 per additional case of CIN identified.Interpretation: HPV DNA testing was more costly but was associated with significantly less loss to follow-up. It may detect more cases... INSET: Terminology.


Related Articles

  • HPV DNA test.  // Taber's Cyclopedic Medical Dictionary (2009);2009, Issue 21, p1095 

    A definition of the medical term "HPV DNA test," which refers to a test to determine whether cancer-causing variant of human papillomavirus are present in the endo- or ectocervix of patients undergoing Papanicolaou (PAP) testing, is presented.

  • Get ready for changes in HPV DNA testing.  // Contraceptive Technology Update;Jun2009, Vol. 30 Issue 6, p67 

    The Food and Drug Administration has approved two new tests for human papillomavirus (HPV): the Cervista HPV 16/18 test, which detects the DNA sequences for HPV types 16 and 18 in cervical cells, and the Cervista HPV HR test, which detects essentially all of the high-risk HPV types in cervical...

  • Safe thresholds for hybrid capture 2 test in primary cervical screening. Sasieni, Peter; Castanon, Alejandra // BMJ: British Medical Journal (Overseas & Retired Doctors Edition;5/28/2011, Vol. 342 Issue 7808, p1159 

    In this article, the authors present their views about the testing for human papil-lomavirus (HPV) DNA with hybrid capture 2. They say that it has been shown by substantial evidence that testing for HPV DNA with hybrid capture 2 is more sensitive but less specific than cytology at detecting high...

  • An economic analysis of human papillomavirus triage for the management of women with atypical and abnormal Pap smear results in Germany. Sheriff, Sara K.; Petry, K. Ulrich; Ikenberg, Hans; Crouse, Geoffrey; Mazonson, Peter D.; Santas, Christopher C. // European Journal of Health Economics;Jun2007, Vol. 8 Issue 2, p153 

    We developed decision-analytic models to determine the cost effectiveness of incorporating human papillomavirus (HPV) testing into the management of atypical and abnormal Pap smear results in Germany. The models compare three management strategies: (1) repeat Pap smear, (2) triage with HPV DNA...

  • Uloga tipizacije humanog papiloma virusa i citologije u ranom otkrivanju recidiva cervikalne intraepitelne neoplazije. Živadinović, Radomir; Lilić, Vekoslav; Djordjević, Biljana; Stanojević, Zorica; Petrić, Aleksandra; Lilić, Goran // Vojnosanitetski Pregled: Military Medical & Pharmaceutical Journ;Apr2011, Vol. 68 Issue 4, p314 

    No abstract available.

  • Quicker post-Pap anxiety relief. Strote, Mary Ellen; Cohen, Carol // Shape;Sept2001, Vol. 21 Issue 1, p86 

    Reports on the study published in the 'Journal of the National Cancer Institute' on the effectiveness of human papillomavirus infection testing in identifying women who needed treatment for precancerous or cancerous conditions. Importance of the study to women who received ambiguous Pap test...

  • Adding HPV test to pap smears improves cervical screenings. Fuerst, Mark L. // Dermatology Times;Feb2000, Vol. 21 Issue 2, p37 

    Reports the use of human papillovirus (HPV) tests and pap smears for cervical cancer screening in Chicago, Illinois. Comparison of the sensitivity of cytology and HPV tests; Use of imiquimoid as topical treatment for cervical dysplasia; Linkage of smoking with HPV infection; Correlation between...

  • Study Finds A Better Way To Test For Cervical CA. Moore, Amy Slugg // RN;Mar2000, Vol. 63 Issue 3, p16 

    Reports on a study which indicated that women can reduce their risk of cervical cancer by doing a vaginal swab themselves and having it tested for the human papillomavirus.

  • Management of Cervical Dysplasia and Human Papillomavirus. Marchese, Marianne // Townsend Letter;Apr2010, Issue 321, p64 

    The article presents information on cervical dysplasia and human papillomavirus (HPV). There are several factors that contribute to cervical cancer risk including smoking, HPV, and multiple sex partners. The feasibility of undergoing HPV testing during the Pap smear is also explained. The...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics