Rescreening of high-risk HPV positive Papanicolaou tests initially screened as negative is a low yield procedure in the era of HPV genotyping.
J Am Soc Cytopathol
; 10(6): 558-564, 2021.
Article
in En
| MEDLINE
| ID: mdl-34103275
ABSTRACT
INTRODUCTION:
Many laboratories rescreen Papanicolaou test slides initially interpreted as negative, but positive for human papillomavirus (HPV) high-risk types, as a quality control measure. We have evaluated the utility of this practice in the era of HPV genotyping as a laboratory improvement project. MATERIAL ANDMETHODS:
Between August 2016 and October 2019, we identified 3618 rescreened Papanicolaou tests with follow-up biopsies. The biopsy results were put into 3 groups 1) Negative; 2) LSIL HPV changes or low-grade squamous intraepithelial lesion; and 3) HSIL high-grade squamous intraepithelial lesion or carcinoma. HPV molecular testing results with subtyping for types 16 and 18 were available for 3117 of these cases.RESULTS:
A total of 530 of 2812 Papanicolaou tests (18.8%) with positive HPV results were reinterpreted as cytologically abnormal after rescreening; 75 (14.2%) had a biopsy result of HSIL. The subset positive for HPV types 16/18 had 38 of 133 cytology positive cases diagnosed as HSIL on biopsy vs. 107 of 935 cytology negative cases diagnosed as HSIL on biopsy (28.6% vs. 11.4%, P < 0.0001). The subset positive for "other" (non-16/18) high-risk HPV types had 37 of 397 cytology positive follow-up HSIL vs. 84 of 1288 cytology negative follow-up HSIL (9.3% vs. 6.5%, P = 0.075).CONCLUSIONS:
Rescreening has the highest yield in specimens positive for types 16/18. However, for this group colposcopy is recommended regardless of cytology findings, reducing the patient benefit. Routine rescreening of cytology negative/HPV positive Papanicolaou tests has reduced utility when HPV subtyping is performed and should be reconsidered.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Papillomaviridae
/
Uterine Cervical Dysplasia
/
Uterine Cervical Neoplasms
/
Papillomavirus Infections
/
Squamous Intraepithelial Lesions of the Cervix
Type of study:
Diagnostic_studies
/
Etiology_studies
/
Prognostic_studies
/
Risk_factors_studies
/
Screening_studies
Limits:
Female
/
Humans
Language:
En
Journal:
J Am Soc Cytopathol
Year:
2021
Document type:
Article
Affiliation country:
Tailandia