Women ≥30 years of age with low grade squamous intraepithelial lesion (LSIL) have low positivity rates when cotested for high-risk human papillomavirus: Should we reconsider HPV triage for LSIL in older women?

2009 ◽  
Vol 38 (6) ◽  
pp. 407-412 ◽  
Author(s):  
Michael J. Thrall ◽  
Debora A. Smith ◽  
Dina R. Mody
Keyword(s):  
Human Papillomavirus ◽  
High Risk ◽  
Older Women ◽  
Low Grade ◽  
Squamous Intraepithelial Lesion ◽  
Intraepithelial Lesion

Characteristics of high-risk human papillomavirus infection in women with abnormal cervical cytology: a population-based study in Shanxi Province, China

2019 ◽  
Author(s):  
Li Song ◽  
Yuanjing Lyu ◽  
Ling Ding ◽  
Xiaoxue Li ◽  
Wen Gao ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Human Papillomavirus ◽  
High Risk ◽  
Hpv Infection ◽  
Cervical Cytology ◽  
Shanxi Province ◽  
Low Grade ◽  
Squamous Intraepithelial Lesion ◽  
Abnormal Cervical Cytology ◽  
Intraepithelial Lesion

Abstract Background: High-risk human papillomavirus (HR-HPV) infection is widely known as the major cause of cervical intraepithelial neoplasia (CIN) and cervical cancer and it’s characteristics vary greatly in different population. Women with abnormal cervical cytology could increase the risk of cervical cancer, however, HR-HPV infection characteristics in women with abnormal cervical cytology remains unclear. Methods: This study was based on baseline survey of the CIN Cohort established in Shanxi Province, China. A total number of 2300 women with cervical abnormalities were enrolled in this study. All participants gave informed consent and agreed to HPV and thinprepcytologic test (TCT). Each individual completed a questionnaire about characteristics related to HPV infection. Results: The overall prevalence of HR-HPV in 2300 women was 32.0%, and the proportion of single and multiple HR-HPV infections were 70.2% and 29.8% in HR-HPV infection women, respectively. The top five HR-HPV genotypes were ranked as HPV16, HPV58, HPV52, HPV53 and HPV51. The prevalence of HR-HPV in atypical squamous cells of undetermined significance (ASC-US), low-grade squamous intraepithelial lesion (LSIL) and high-grade squamous intraepithelial lesion and above(HSIL+) were 30.8%, 36.5% and 54.9%, respectively, showing an increasing trend with the severity of cervical cytology ( χ 2 trend =13.952; p <0.001). The women aged 35~45 years, with lower education level, less frequency of bathing, multiple gravidity, multiple parity, history of gynecological diseases and premenopausal women were prone to HR-HPV infection. Conclusions: We defined the characteristics related to HR-HPV infection in abnormal cervical cytology women, and provided an insight for the development and deeply research of HPV vaccine.

Colposcopy referral rate can be reduced by high-risk human papillomavirus triage in the management of recurrent atypical squamous cells of undetermined significance or low-grade squamous intraepithelial lesion cytology in Finland

2012 ◽  
Vol 23 (7) ◽  
pp. 485-489 ◽  
Author(s):  
M Jakobsson ◽  
J Tarkkanen ◽  
E Auvinen ◽  
R Häkkinen ◽  
P Laurila ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
High Risk ◽  
Study Groups ◽  
Referral Rate ◽  
Cervical Cytology ◽  
Low Grade ◽  
Squamous Intraepithelial Lesion ◽  
Squamous Cells ◽  
Intraepithelial Lesion ◽  
Undetermined Significance

The aim of this study was to establish whether a combination of high-risk human papillomavirus (hrHPV) testing and cervical cytology could reduce colposcopy referral among women with atypical squamous cells of undetermined significance (ASCUS) or low-grade squamous intraepithelial lesion cytology. We randomized 598 women in the Helsinki area, Finland into three study groups. Different strategies of hrHPV testing, cytology and colposcopy with biopsy were used; subsequent hrHPV test results and cytological findings were compared with histology. The rates of hrHPV positivity and CIN2+ were compared. In total, 62.5% of all samples were hrHPV-positive. Altogether 45 (12.7%) CIN2 or worse (CIN2+) lesions were found in study groups A and B. Among hrHPV-positive women the rate of CIN2+ was 19.0% ( n = 43), in contrast with 1.6% ( n = 2) among hrHPV-negative women (relative risk = 12.2, 95% confidence interval [CI] 3.6–81.1, P < 0.001). Among all hrHPV-negative women whose cytological findings were normal or ASCUS, dysplastic lesions were uncommon ( n = 4/119, 3.4%), and all were CIN1. If these women had not been referred to colposcopy, the number of colposcopies would have been reduced by 33.6%. We conclude that hrHPV testing combined with repeat cervical cytology had a high negative predictive value in patients with recurrent low-grade cervical cytology. This could reduce the referral rate to colposcopy without jeopardizing patient safety.

scholarly journals Atypical Squamous Cells of Undetermined Significance: Bethesda Classification and Association with Human Papillomavirus

2011 ◽  
Vol 2011 ◽  
pp. 1-9 ◽  
Author(s):  
Ana Cristina Macêdo Barcelos ◽  
Márcia Antoniazi Michelin ◽  
Sheila Jorge Adad ◽  
Eddie Fernando Candido Murta
Keyword(s):  
Human Papillomavirus ◽  
High Risk ◽  
Trichomonas Vaginalis ◽  
Low Grade ◽  
Squamous Intraepithelial Lesion ◽  
Squamous Cells ◽  
Hpv Test ◽  
Intraepithelial Lesion ◽  
High Risk Hpv ◽  
Undetermined Significance

Introduction. To analyze patients with atypical squamous cells of undetermined significance (ASCUS) through a cytology review and the presence of microbiological agents, with consideration of colposcopy and semiannual tracking.Methods. 103 women with ASCUS were reviewed and reclassified: normal/inflammatory, ASCUS, low-grade squamous intraepithelial lesion (LSIL), or high-grade squamous intraepithelial lesion (HSIL). If ASCUS confirmed, it was subclassified in reactive or neoplastic ASCUS, ASC-US, or ASC-H; and Regione Emilia Romagna Screening Protocol. Patients underwent a colposcopic examination, and test forCandidasp., bacterial vaginosis,Trichomonas vaginalis, and human papillomavirus (HPV) were performed.Results. Upon review, ASCUS was diagnosis in 70/103 (67.9%), being 38 (54.2%) reactive ASCUS and 32 (45.71%) neoplastic ASCUS; 62 (88.5%) ASC-US and 8 (11.41%) ASC-H. ASCUS (Regione Protocol), respectively 1-5: 15 (21.4%), 19 (27.1%), 3 (27.1%), 16 (22.8%), and 1 (1.4%). A higher number of cases of cervical intraepithelial neoplasia (CIN) II/III in the biopsies of patients with ASC-H compared to ASC-US (P=.0021). High-risk HPV test and presence of CIN II/III are more frequent in ASC-H than ASC-US (P=.031).Conclusions. ASC-H is associated with clinically significant disease. High-risk HPV-positive status in the triage for colposcopy of patients with ASC-US is associated with increased of CIN.

scholarly journals Association between asymptomatic sexually transmitted infections and high-risk human papillomavirus in cervical lesions

2019 ◽  
Vol 47 (11) ◽  
pp. 5548-5559 ◽  
Author(s):  
Lei Wang ◽  
Lizhe Zhu ◽  
Han Li ◽  
Nan Ma ◽  
Huifang Huang ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Human Papillomavirus ◽  
High Risk ◽  
Sexually Transmitted Infections ◽  
Low Grade ◽  
Squamous Intraepithelial Lesion ◽  
Cervical Lesions ◽  
Sexually Transmitted ◽  
Increased Risk ◽  
Intraepithelial Lesion

Objective This study aimed to determine the association of asymptomatic sexually transmitted infections (STIs), including Ureaplasma urealyticum (UU), Mycoplasma hominis (MH), Mycoplasma genitalium, Chlamydia trachomatis, and herpes simplex virus type 2, with high-risk human papillomavirus (hrHPV) in cervical intraepithelial lesions and neoplasms. Methods A total of 320 hrHPV-positive and 160 hrHPV-negative women were divided into high-grade squamous intraepithelial lesion (HSIL) + invasive cervical cancer and low-grade squamous intraepithelial lesion + normal subgroups, respectively, on the basis of pathological cervical lesions. Cervical brush specimens were amplified and hybridized using polymerase chain reaction kits. Results MH was associated with hrHPV infection, but not with specific hrHPV genotypes or with single or multiple genotypes. Coinfection of hrHPV and UU serotype 14 (Uup14) showed an increased risk of HSILs and cervical carcinoma (odds ratio [OR]: 12.541, 95% confidence interval [CI]: 3.625–43.390). U. urealyticum biovar (Uuu) and Uup1 infections showed a similar increased risk (OR: 11.646, 95% CI: 1.493–90.850; OR: 7.474, 95% CI: 1.140–49.015, respectively) without hrHPV. Conclusions Asymptomatic STIs are widespread. This study shows an association between UU subtypes and cervical cancer, providing new insight into cervical lesion etiology. Screening for MH, Uup14, Uup1, and Uuu is important under different hrHPV statuses.

Human Papillomavirus Testing and Reporting Rates: Practices of Participants in the College of American Pathologists Interlaboratory Comparison Program in Gynecologic Cytology in 2006

2008 ◽  
Vol 132 (8) ◽  
pp. 1290-1294 ◽  
Author(s):  
Ann T. Moriarty ◽  
Mary R. Schwartz ◽  
Galen Eversole ◽  
Marilee Means ◽  
Amy Clayton ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
Interlaboratory Comparison ◽  
Low Grade ◽  
Hpv Testing ◽  
Squamous Intraepithelial Lesion ◽  
Papanicolaou Test ◽  
Frequency Distributions ◽  
Squamous Cells ◽  
Hpv Test ◽  
Intraepithelial Lesion

Abstract Context.—Oncogenic, high-risk human papillomavirus (HR-HPV) testing is used to evaluate women who are older than 20 years with atypical squamous cells of undetermined significance (ASC-US) and in conjunction with a screening Papanicolaou test in women older than 30 years. Objectives.—To evaluate the 2006 laboratory practice data from laboratories incorporating human papillomavirus (HPV) testing with the Papanicolaou test. Design.—To use the College of American Pathologists (CAP) Supplemental Questionnaire Survey for 2006 to determine laboratory practices of participants in the CAP Interlaboratory Comparison Program in Cervicovaginal Cytology. Results.—A total of 679 laboratories responded to the questionnaire. Most (73%) refer HPV testing to reference laboratories. Nine percent perform HPV testing in cytology. Forty-five percent offer low-risk HPV (LR-HPV) testing. The most common reflex is ASC-US, although HR-HPV is also offered with low-grade squamous intraepithelial lesion (LSIL), high-grade squamous intraepithelial lesion (HSIL), or any other Papanicolaou test result. Digene Hybrid Capture II is the most common method. Human papilloma virus median test volumes are 55 monthly. Frequency distributions of HPV test volumes are significantly different from those found in 2003. Laboratories performing in-house testing reported significantly higher monthly HPV volumes (P &lt; .001). Median rates for HR-HPV positivity are 36.6% for ASC-US, 50.0% for atypical squamous cells, cannot exclude HSIL (ASC-H), and 4% for women 30 years of age and older in conjunction with a screening Papanicolaou test. Conclusions.—Reference HPV testing remains the most common pattern. The most common reflex indication is for ASC-US, but HPV testing is modified locally to include a variety of scenarios. LR-HPV testing is commonly offered despite its lack of clinical significance. These data form a baseline for ongoing monitoring of HPV testing practice trends.

scholarly journals Bethesda 2014 Implementation and Human Papillomavirus Primary Screening: Practices of Laboratories Participating in the College of American Pathologists PAP Education Program

2019 ◽  
Vol 143 (10) ◽  
pp. 1196-1202 ◽  
Author(s):  
Diane Davis Davey ◽  
Rhona J. Souers ◽  
Kelly Goodrich ◽  
Dina R. Mody ◽  
Sana O. Tabbara ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
Education Program ◽  
Cervical Cytology ◽  
Current Status ◽  
Low Grade ◽  
Hpv Testing ◽  
Squamous Intraepithelial Lesion ◽  
Primary Screening ◽  
Intraepithelial Lesion ◽  
Bethesda System

Context.— Cervical cancer screening laboratory practices may evolve with new terminology and technologies. Objective.— To investigate changes in cervical cytopathology practice resulting from the 2014 Bethesda System updates and screening technologies. Design.— Questionnaires accompanied 2016 and 2017 mailings of the College of American Pathologists PAP Education program. Results.— In 2016, most laboratories surveyed had adopted or were planning to adopt 2014 Bethesda System updates, and the majority (53%; 365 of 689) used an age cutoff of 45 for reporting benign-appearing endometrial cells. However, 51.3% (354 of 690) of laboratories used the term low-grade squamous intraepithelial lesion, cannot exclude high-grade squamous intraepithelial lesion, for cases with indeterminate features, and 44.9% (298 of 664) of laboratories used a 5000-cell cutoff for minimum squamous cellularity for posthysterectomy and posttherapy specimens. Reporting rates for cervical cytology metrics changed very little from 2013 to 2016, and the median ratio of atypical squamous cells to squamous intraepithelial lesion cases was 1.9 for ThinPrep and 1.8 for SurePath preparations. Most laboratories (59.4%; 389 of 655) did not offer stand-alone primary human papillomavirus (HPV) testing in 2017, and primary HPV testing accounted for a low proportion of HPV testing volumes. The Roche Cobas method was the most common platform for HPV primary screening. Conclusions.— These questionnaire surveys provide data about the current status of cervical cytology screening, including changes related to the 2014 Bethesda System updates and the adoption of HPV primary screening techniques.

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