Cervicography and HPV DNA Testing as Triage Criteria for Patients with Abnormal Pap Smear

ObjectivesUsing mathematical modelling, we have previously shown that the prevalence of infection with Trichomonas vaginalis (TV) is likely to increase in the general population in Australia with the transition from Pap smear-based cervical screening to human papillomavirus (HPV) DNA testing. Here we use the existing model to estimate the level of supplemental testing required to maintain TV control.MethodsA compartmental mathematical model describing the transmission of TV in the general heterosexual population in Australia was used to evaluate the impact of a range of screening scenarios on TV prevalence over time following the transition to HPV DNA testing for cervical screening. Scenarios considered were the inclusion of a TV test with the HPV test and the addition of TV testing to routine chlamydia testing conducted in primary care.ResultsOur modelling suggests that with sufficient coverage, inclusion of TV testing with routine chlamydia screening in general practice, TV prevalence can be reduced over time, but at the current reported coverage will gradually increase following the transition to HPV testing. Inclusion of TV testing with HPV testing in the cervical screening programme is preferable to no supplemental testing but is considerably less effective in controlling TV.ConclusionsThese findings support the inclusion of TV testing with routine chlamydia testing of young people.

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The use of HPV-DNA testing combined with Pap smear in detection of pre-invasive disease of the cervix

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20175226 ◽

2017 ◽

Vol 6 (12) ◽

pp. 5192

Author(s):

Fayrouz A. Nwesar ◽

Tawfik Abdel Salam T. ◽

Marwa Hanafi M. ◽

Layla K. Younis ◽

Ziad S. Abou-Zeid ◽

...

Keyword(s):

Pap Smear ◽

Invasive Disease ◽

Punch Biopsy ◽

Dna Testing ◽

Cancer Cervix ◽

Major Health Problem ◽

Dna Test ◽

Hpv Dna ◽

Hpv Dna Testing ◽

Hpv Dna Test

Background: Cancer cervix constitutes a major health problem worldwide. It is one of the most common female malignancy in both incidence and mortality. Cancer cervix has many risk factors, the most important one is persistent infection with one of HPV high risk types. Its morbidity and mortality can be reduced by frequent screening and early diagnosis. So that, several studies have been conducted in recent years in order to find better tests for screening for pre-invasive disease of the cervix and so early intervention and better prognosis. This study aimed to compare the sensitivity of Pap test and HPV DNA test as screening tests for pre-invasive disease of the cervix.Methods: 100 females from those attending Alexandria University gynaecologic clinic for causes rather than cancer cervix were subjected to Pap smear and cervical swab for HPV-DNA testing at the same setting. Cases of HSIL or positive HPV were subjected to VIA test, colposcopy and cervical punch biopsy was taken if aceto-whitening of the cervix or any other abnormality was found. Cases with ASCUS or LSIL were re-smeared after 3-6 months, if persistent or progressive pathology, colposcopy and punch biopsy from acetowhite areas were taken.Results: 21 cases (21%) were HPV positive and 66 cases (66%) were positive for intraepithelial lesions (37% ASCUS, 18% LSIL and 11% HSIL) with re-smearing there were 3 persistent ASCUS cases (8.1%) and 5 LSIL cases (27.78%). Colposcopy done, and biopsies were taken from 10 HSIL cases (90.1%), 5 LSIL (27.8%), 3 ASCUS (8.1%) and 10 HPV positive cases (62.5%). With significant relationship between colposcopic findings and HPV-DNA positivity and abnormal cytology. Biopsies were 18; 14 were CIN I and 4 were CIN II.Conclusions: HPV-DNA positivity has positive association with HSIL. Pap smear is an easy cheap method for screening. HPV-DNA test is less sensitive than cytology as a method for screening.

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