A Luyten1, K U Petry1. 1. Frauenklinik im Klinikum Wolfsburg, Wolfsburg.
Abstract
Introduction: The use of HPV screening for the triage of ASC-US (atypical squamous cells of undetermined significance) cytology results has been established as a sound standard by international trials whereas the data for other cytology findings are in part contradictory. There is a lack of long-term studies on the use of HPV triage in Germany. Materials and Methods: For the present study data from a primary HPV screening project involving women aged over 30 years, ongoing since 2006, and an epidemiological study on women aged between 20 and 27 years, ongoing since 2009, were used. Upon recruitment, all women underwent a smear test for cytology and screening for "high-risk" HPV using Hybrid Capture 2 (HC2). If both tests were positive or if there were persisting remarkable cytology findings or a positive HPV test, then clarification by colposcopy was performed. Results: Altogether, among 282 women with Pap II-p (ASC-US), Pap III (ASC-H) or Pap IIID (LSIL + CIN2) and negative HPV test there was no case of CIN3+. Among the women under 30 years of age, however, 69 % (ASC-US) to 85 % (LSIL + CIN2) of the remarkable findings were HPV positive, also among the older women with Pap IIID, the 71 % prevalence of HPV was too high for a triage and even without triage there was a 23 % risk for CIN3+. On the other hand, of the women over 30 years old with ASC-US (Pap II-p) findings, only 21 % were positive for HPV and the risk for CIN3+ in this group was high at 29 %. Also for ASC-H (Pap III) findings in the age group of over 30 years with an HPV prevalence of 56 % there was an efficient triage for CIN3+. Discussion: In summary, the HPV triage of ASC-US (Pap II-p) findings in women aged over 30 years was found to be efficient; in contrast, LSIL + CIN2 (Pap IIID) findings in this age group justified an immediate referral to colposcopy whereas cytology control appeared to be sufficient for younger women.
Introduction: The use of HPV screening for the triage of ASC-US (atypical squamous cells of undetermined significance) cytology results has been established as a sound standard by international trials whereas the data for other cytology findings are in part contradictory. There is a lack of long-term studies on the use of HPV triage in Germany. Materials and Methods: For the present study data from a primary HPV screening project involving women aged over 30 years, ongoing since 2006, and an epidemiological study on women aged between 20 and 27 years, ongoing since 2009, were used. Upon recruitment, all women underwent a smear test for cytology and screening for "high-risk" HPV using Hybrid Capture 2 (HC2). If both tests were positive or if there were persisting remarkable cytology findings or a positive HPV test, then clarification by colposcopy was performed. Results: Altogether, among 282 women with Pap II-p (ASC-US), Pap III (ASC-H) or Pap IIID (LSIL + CIN2) and negative HPV test there was no case of CIN3+. Among the women under 30 years of age, however, 69 % (ASC-US) to 85 % (LSIL + CIN2) of the remarkable findings were HPV positive, also among the older women with Pap IIID, the 71 % prevalence of HPV was too high for a triage and even without triage there was a 23 % risk for CIN3+. On the other hand, of the women over 30 years old with ASC-US (Pap II-p) findings, only 21 % were positive for HPV and the risk for CIN3+ in this group was high at 29 %. Also for ASC-H (Pap III) findings in the age group of over 30 years with an HPV prevalence of 56 % there was an efficient triage for CIN3+. Discussion: In summary, the HPV triage of ASC-US (Pap II-p) findings in women aged over 30 years was found to be efficient; in contrast, LSIL + CIN2 (Pap IIID) findings in this age group justified an immediate referral to colposcopy whereas cytology control appeared to be sufficient for younger women.
Entities:
Keywords:
HPV; Pap II-p; Pap IIID; human papillomavirus; triage
Authors: Esther L Moss; Marc Arbyn; Elizabeth Dollery; Simon Leeson; Karl Ulrich Petry; Pekka Nieminen; Charles W E Redman Journal: Eur J Obstet Gynecol Reprod Biol Date: 2013-07-25 Impact factor: 2.435
Authors: K Ulrich Petry; Gerd Böhmer; Thomas Iftner; Philip Davies; Oliver Brummer; Henning Kühnle Journal: Am J Obstet Gynecol Date: 2002-01 Impact factor: 8.661
Authors: Anne Szarewski; Laurence Ambroisine; Louise Cadman; Janet Austin; Linda Ho; George Terry; Stuart Liddle; Roberto Dina; Julie McCarthy; Hilary Buckley; Christine Bergeron; Pat Soutter; Deirdre Lyons; Jack Cuzick Journal: Cancer Epidemiol Biomarkers Prev Date: 2008-10-28 Impact factor: 4.254
Authors: Alexander Luyten; Nina Buttmann-Schweiger; Katrin Luyten; Claudia Mauritz; Axel Reinecke-Lüthge; Martina Pietralla; Chris J L M Meijer; Karl Ulrich Petry Journal: Int J Cancer Date: 2014-02-27 Impact factor: 7.396
Authors: Karl Ulrich Petry; Alexander Luyten; Annika Justus; Angelika Iftner; Sarah Strehlke; Axel Reinecke-Lüthge; Elisabeth Grunwald; Renate Schulze-Rath; Thomas Iftner Journal: BMC Infect Dis Date: 2013-03-13 Impact factor: 3.090
Authors: K-U Petry; S Menton; M Menton; F van Loenen-Frosch; H de Carvalho Gomes; B Holz; B Schopp; S Garbrecht-Buettner; P Davies; G Boehmer; E van den Akker; T Iftner Journal: Br J Cancer Date: 2003-05-19 Impact factor: 7.640
Authors: Hans Ikenberg; Christine Bergeron; Dietmar Schmidt; Henrik Griesser; Francisco Alameda; Claudio Angeloni; Johannes Bogers; Roger Dachez; Karin Denton; Jalil Hariri; Thomas Keller; Magnus von Knebel Doeberitz; Heinrich H Neumann; Luis M Puig-Tintore; Mario Sideri; Susanne Rehm; Ruediger Ridder Journal: J Natl Cancer Inst Date: 2013-10-04 Impact factor: 13.506
Authors: Frederik A Stuebs; Martin C Koch; Anna K Dietl; Werner Adler; Carol Geppert; Arndt Hartmann; Antje Knöll; Matthias W Beckmann; Grit Mehlhorn; Carla E Schulmeyer; Paul Gass Journal: Diagnostics (Basel) Date: 2022-07-19