Detection of cervical precancer and cancer in a hospital population; benefits of testing for human papillomavirus |
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Authors: | Dalstein V Riethmuller D Sautière J L Prétet J L Kantelip B Schaal J P Mougin C |
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Affiliation: | Laboratoire de Biologie Cellulaire et Moléculaire, CHU de Besan?on, H?pital Jean Minjoz, 25030 Besan?on cedex, France. |
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Abstract: | The aim was to determine the relevance of human papillomavirus (HPV) testing in identifying high-grade cervical intraepithelial neoplasia or worse (CIN2/3+) in a hospital population (n=3574) characterised by a high rate of cytological abnormalities and high-risk HPV infections. According to the results of the initial Papanicolaou and HPV test, women were directly referred for colposcopy/biopsy or recalled for a control visit. Sensitivity and specificity were corrected for verification bias. HPV-testing sensitivity was 94.3%, higher than that of cytological testing at any cut-off point (65.1%-86.8%), while specificity was greater for cytology than for HPV testing (99.3% or 91.8% versus 83.4%). The combination of both tests allowed 100% sensitivity and negative predictive value. We conclude that HPV testing is a relevant tool for the detection of cervical disease. The best way of combining cytology and HPV detection in screening programmes should be evaluated in large-scale studies. |
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