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Human papillomavirus 'reflex' testing as a screening method in cases of minor cytological abnormalities
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm , Centre for Clinical Research, County of Västmanland.
2008 (English)In: British Journal of Cancer, ISSN 0007-0920, Vol. 99, no 4, 563-568 p.Article in journal (Refereed) Published
Abstract [en]

The aim was to evaluate human papillomavirus (HPV) 'reflex genotyping' in cases of minor cytological abnormalities detected in the gynaecological screening programme in Stockholm, Sweden. Liquid-based cytology samples showing minor cytological abnormalities were analysed using HPV genotyping (Linear Array, Roche diagnostics). Colposcopically directed cervical biopsies were obtained and the HPV test results were correlated with the histological results. In all, 63% (70/112) of the samples were high-risk (HR) HPV (HR-HPV) positive. A statistically significant correlation was found between high-grade cervical lesions and HR-HPV (P = 0.019), among which HPV 16, 18, and 31 were the most important. The negative predictive value of HR-HPV detection for histologically confirmed high-grade lesions was 100%. An age limit for HPV reflex testing may be motivated in cases of low-grade squamous intraepithelial neoplasia (LSIL), because of high HR-HPV prevalence among younger women. By using HPV reflex genotyping, additional extensive workup can safely be avoided in about 50% of all cases of atypical squamous cells of undetermined significance ( ASCUS) and LSIL among women > ;= 30 years. This screening strategy could potentially reduce the total abnormal cytology-reporting rate in the Swedish screening programme by about 1% and provide more accurately directed follow-up, guided by cytological appearance and HPV test results.

Place, publisher, year, edition, pages
2008. Vol. 99, no 4, 563-568 p.
Keyword [en]
human papilloma virus (HPV), genotyping, liquid-based cytology (LBC), atypical squamous cells of undetermined significance (ASCUS), low-grade squamous intraepithelial lesion (LSIL), cervical intraepithelial neoplasia (CIN)
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-109149DOI: 10.1038/sj.bjc.6604504ISI: 000258359900002OAI: oai:DiVA.org:uu-109149DiVA: diva2:248988
Available from: 2009-10-09 Created: 2009-10-09 Last updated: 2009-10-09Bibliographically approved

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