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  • Title: An evaluation of human papillomavirus testing for intermediate- and high-risk types as triage before colposcopy.
    Author: Hatch KD, Schneider A, Abdel-Nour MW.
    Journal: Am J Obstet Gynecol; 1995 Apr; 172(4 Pt 1):1150-5; discussion 1155-7. PubMed ID: 7726250.
    Abstract:
    OBJECTIVE: Our purpose was to evaluate the role of testing for intermediate- and high-risk human papillomavirus by use of a hybrid capture technique for predicting which patients with abnormal Papanicolaou smears are most likely to have squamous intraepithelial lesions or cancer. STUDY DESIGN: Cervical cytologic studies, hybrid capture tests, and colposcopically directed biopsies were performed on 311 women referred to the colposcopy clinics with abnormal cytologic study results. RESULTS: There was a highly significant correlation (p < 0.0001) between a positive human papillomavirus test and the finding of squamous intraepithelial lesions or invasive cancer. The sensitivity of human papillomavirus testing to detect high-grade squamous intraepithelial lesions was 74% when it was used alone and increased to 91% when coupled with abnormal cytologic study results of low- or high-grade squamous intraepithelial lesions or cancer. In 44 women with atypical squamous cells of undetermined significance on cytologic study, human papillomavirus testing identified six of 10 who had high-grade squamous intraepithelial lesions. For the 96 patients with low-grade squamous intraepithelial lesions, human papillomavirus testing was successful in identifying 29 of the 37 with high-grade squamous intraepithelial lesions (sensitivity 0.76). CONCLUSION: Testing for intermediate- and high-risk human papillomavirus types by hybrid capture improves the detection of high-grade squamous intraepithelial lesions in women with atypical squamous cells of undetermined significance and low-grade squamous intraepithelial lesions over cytologic study used alone.
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