A comparison of the human papillomavirus test and Papanicolaou smear as a second screening method for women with minor cytological abnormalities
Författare
Summary, in English
Background. Of the estimated one million Papanicolaou (pap) smears performed annually in Sweden, about 4% show any degree of abnormality. Approximately, 1% of these cases contain moderate or severe atypia (high-grade squamous intraepithelial lesions) and the rest contain low-grade atypia. Recommendations for the management of minor abnormalities vary in various parts of Sweden. Generally, a second Pap smear is obtained 4-6 months after the first one showing low-grade atypia. The aim of this study is to compare the sensitivity of human papilloma virus (HPV)-DNA testing for the detection of cervical intraepithelial neoplasia (CIN) 2-3 with that of a second Pap smear in women, who had low-grade atypia in their first Pap smear. Methods. Women with low-grade atypia in the Stockholm area, detected at a population-based cytology screening, were enrolled. A repeat Pap smear, HPV test, and colposcopically directed biopsies were obtained. For the detection of HPV, Hybrid Capture II (HC II) was used. Results. The HPV-DNA test was positive in 66% of the 177 participating women. The sensitivity of the second Pap smear and HPV-DNA test to detect CIN 2-3 was 61 (95% CI = 45-74) and 82% (95% CI = 67-91), respectively. The positive and negative predictive values of HPV testing were 27 (95% CI = 18-35) and 89% (95% CI = 80-97), respectively. Conclusions. In Sweden, a second Pap smear is often obtained for the follow-up of women with low-grade atypia. The results of our study show that compared to the second Pap smear, HPV testing with HC II is a more sensitive method for detecting high-grade lesions.
Avdelning/ar
Publiceringsår
2005
Språk
Engelska
Sidor
996-1000
Publikation/Tidskrift/Serie
Acta Obstetricia et Gynecologica Scandinavica
Volym
84
Issue
10
Länkar
Dokumenttyp
Artikel i tidskrift
Förlag
Wiley-Blackwell
Ämne
- Obstetrics, Gynecology and Reproductive Medicine
Nyckelord
- Pap smear
- CIN
- HPV
- screening
Status
Published
Forskningsgrupp
- Clinical Microbiology, Malmö
ISBN/ISSN/Övrigt
- ISSN: 1600-0412