Prior knowledge of HPV status improves detection of CIN2 by cytology screening


OBJECTIVE: The objective of the study was to investigate whether knowledge of human papillomavirus (HPV) deoxyribonucleic acid test results increases sensitivity of guided cytology screening for the detection of cervical intraepithelial neoplasia (CIN)-2 or higher-grade cervical lesions.

STUDY DESIGN: This was a prospective colposcopy-controlled study of 2905 BD SurePath samples to identify cases with CIN2+ within a 24 month follow-up period. Sensitivity and specificity to detect CIN2+ was evaluated, comparing guided cytology screening with and without prior knowledge of HPV status.

RESULTS: Prior knowledge of HPV status resulted in significantly higher detection rate of CIN2+ compared with screening blinded to HPV status (P = .005) with limited loss of specificity (P = .026). Gain in sensitivity is higher in older women (43.8%, P = .008) vs in younger women (10.2%, P = .317), whereas loss of specificity is more pronounced in younger women (P < .001) vs older women (P = .729).

CONCLUSION: Guided cytological screening performed with prior knowledge of HPV status results in an improved detection of CIN2 or higher-grade lesions.


Authors & affiliation: 
From the Department of Molecular Pathology (RIATOL) Sonic Healthcare, Antwerp, Belgium (Drs Benoy, Sahebali, Bogers, and Depuydt) and Department of Applied Molecular Biology Research (AMBIOR), University of Antwerp (Dr Bogers), Antwerp; the International Centre for Reproductive Health (ICRH), Ghent University (Drs Vanden Broeck and Temmerman), and Jan Palfijn Hospital and Department of Obstetrics and Gynaecology, University Hospital (Dr Ruymbeke), Ghent; and the Unit of Cancer Epidemiology/Belgian Cancer Centre, Scientific Institute of Public Health, Brussels (Dr Arbyn), Belgium.
Published In: 
American Journal of Obstetrics & Gynecology DECEMBER 2011 volume205 issue6 article number569.e1
Publication date: 
Friday, December 16, 2011