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Human papillomavirus testing leads to faster diagnosis of cervical disease.

A large observational study has found that testing for human papillomavirus (HPV) in women with abnormal cervical cytology leads to faster diagnosis of cervical disease and fewer missed cases.

Researchers analysed results of cervical cytology from 457 317 women with a mean age of 39.8 years who were in screening programmes in New Mexico, USA, from January 2007 to December 2012. They assessed the effect that HPV testing after an abnormal screening cytology result had on diagnosis of cervical cancer and rates of biopsy and loop electrosurgical excision procedures.

Their results were reported in JAMA Oncology and showed that nearly 4.5% of the first cytology results per woman in the screening programme were reported as atypical squamous cells of undetermined significance. Of these, 80% were tested for HPV and in these women, the time to detecting abnormalities of cervical intraepithelial neoplasia grade 3 or worse (CIN3+) was much shorter in those who were being tested for HPV. In addition, the rate of loop electrosurgical excision procedures over 5 years was 20% higher in women who had HPV testing, resulting in increased detection of CIN2+ and CIN3+, than in women who were not tested for HPV.

The authors point out that nearly all the high-grade disease occurred in the 43.1% of women who were HPV-positive, allowing colposcopy and related resources to be focused on this group.

Cuzick J, Myers O, Lee J-H, et al. Outcomes in women with cytology showing atypical squamous cells of undetermined significance with vs without human papillomavirus testing. JAMA Oncol 2017 (epub 22 June 2017).

B Farham


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Title Annotation:30 days in medicine
Author:Farham, B.
Publication:South African Medical Journal
Article Type:Brief article
Date:Aug 1, 2017
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