Predictive Value Of High-Risk Human Papilloma Virus For Cervical Dysplasia
Posted Date: Apr 18, 2024
- Investigator: Rachel Jug
- Specialties: Cancer, Gynecology, Women's Health
- Type of Study: Observational/Survey
Background The United States Preventive Services Task Force (USPSTF) recommendation for cervical cancer screening includes the option to screen with high-risk human papilloma virus (hrHPV) alone but some studies reported hrHPV testing alone missed precancerous and cancerous lesions. In this study, we evaluated the test performance characteristics of hrHPV in detecting cervical dysplasia with cervical cytology and biopsy as comparators. Design We conducted a retrospective analysis of Papanicolaou smears between January-December 2019 performed at our institution with concurrent hrHPV and cytology testing. Cases were identified in the laboratory information system and abstracted data included patient age, hrHPV result, concurrent cytology result, and follow-up cervical biopsy result where available. Chi-square statistics were performed in Excel to calculate sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and p-values for hrHPV predicting dysplasia on concurrent cervical cytology and cervical biopsy samples. Results 3748 cases were identified with concurrent hrHPV and cytology testing and 79 cases with concurrent hrHPV and biopsy results. The sensitivity and specificity of hrHPV for detecting dysplasia on cytology was 70% (95% confidence interval (CI) 60.65%-77.83%) and 98% (95% CI 97.42%-98.37%), respectively. The PPV and NPV of hrHPV for detecting dysplasia on cytology was 53% (95% CI 46.21%-58.77%) and 99% (95% 98.69%-99.23%), respectively (p-value < .00001). The sensitivity and specificity of hrHPV for detecting dysplasia on biopsy was 76% (95% CI 61.13%-86.66%) and 30% (95% CI 14.73%-49.40%), respectively. The PPV and NPV of hrHPV for detecting dysplasia on biopsy was 64% (95% CI 57.03%-70.05%) and 43% (95% 46.59%-61.00%), respectively (p-value < .3). The correlation between hrHPV subtype and level of dysplasia on cytology is depicted in Figure 1 and the correlation between hrHPV subtype and level of dysplasia on biopsy is depicted in Figure 2. Conclusion hrHPV testing alone would have missed 30% of dysplastic samples identified by cytology and 24% of dysplastic samples confirmed by cervical biopsy. hrHPV subtype does not predict degree of dysplasia. These findings support dual cervical cancer screening with cytology and hrHPV testing to ensure timely detection of precancerous lesions and appropriate management.
Criteria:
Null
Keywords:
Papanicalou Smear, Hpv, Cervical Dysplasia
For More Information:
Rachel Jug
NULL
jugrl@ucmail.uc.edu