Detection of cervical precancer and cancer in a hospital population; benefits of testing for human papillomavirus

Eur J Cancer. 2004 May;40(8):1225-32. doi: 10.1016/j.ejca.2004.01.021.

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.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Colposcopy / standards
  • DNA, Viral / analysis
  • Female
  • Follow-Up Studies
  • Hospitalization
  • Humans
  • Mass Screening / methods
  • Middle Aged
  • Papanicolaou Test
  • Papillomaviridae / isolation & purification
  • Papillomavirus Infections / diagnosis*
  • Precancerous Conditions / diagnosis*
  • Precancerous Conditions / virology
  • Sensitivity and Specificity
  • Tumor Virus Infections / diagnosis*
  • Uterine Cervical Dysplasia / diagnosis*
  • Uterine Cervical Dysplasia / virology
  • Uterine Cervical Neoplasms / diagnosis*
  • Uterine Cervical Neoplasms / virology
  • Vaginal Smears / standards

Substances

  • DNA, Viral