Follow-up Findings in Women Aged 30 or Older With a Positive High-Risk Human Papillomavirus Test and a Negative Pap Test

Abstract Context. Atypical glandular cell (AGC) Papanicolaou (Pap) test interpretations are challenging. Most biopsy findings are benign, but AGC results may also reflect highly significant noninvasive neoplastic and malignant histologic outcomes. High-risk human papillomavirus (hrHPV) test use with AGC Pap test results is evolving. Objective. To further evaluate the utility and limitations of hrHPV testing with AGC Pap tests. Design. Hospital records were searched for AGC Pap tests results from June 1, 2005, to August 31, 2007. Cases of AGC with hrHPV tests and histopathologic follow-up were included. Results. Of the 662 women with AGC Pap test results and follow-up analyzed, hrHPV results were available for 309 (46.7%) and were positive in 75 cases (24.3%). Among the 75 cases with hrHPV+ AGC results, 13 (17.3%) had cervical intraepithelial neoplasia grades 2/3, 10 (13.3%) had adenocarcinoma in situ, and 3 (4.0%) had cervical invasive adenocarcinoma, whereas for 234 women with hrHPV− results, 1 (0.4%) had cervical intraepithelial neoplasia grades 2/3, 1 (0.4%) had adenocarcinoma in situ, 1 each (0.4%) had cervical adenocarcinoma and ovarian carcinoma, and 8 (3.4%) had endometrial carcinoma. Conclusions. Positive hrHPV AGC results were most strongly associated with cervical intraepithelial neoplasia grades 2/3 and adenocarcinoma in situ in women younger than 50 years. Positive hrHPV AGC results were also present in all 3 cases of invasive cervical adenocarcinoma in women younger than 50 years. Of note, hrHPV− AGC results were present in 10 of 13 carcinomas (76.9%) detected after AGC Pap tests, all in women 40 years or older with endometrial adenocarcinomas (n = 8), ovarian carcinoma (n = 1), and cervical adenosquamous carcinoma in a woman (n = 1) in her 50s. Testing for hrHPV after AGC Pap testing was most helpful in the detection of cervical intraepithelial neoplasia grades 2/3, adenocarcinoma in situ, and invasive cervical adenocarcinomas in women younger than 50 years.

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Follow Up and Outcomes for Patients with Negative Papanicolaou (Pap) Test and Positive High-Risk Human Papillomavirus (hrHPV+) Co-testing

Journal of the American Society of Cytopathology ◽

10.1016/j.jasc.2017.06.077 ◽

2017 ◽

Vol 6 (5) ◽

pp. S31

Author(s):

Elza Matrova ◽

Kristen Wilkins ◽

Robert Cabay ◽

Odile David

Keyword(s):

Human Papillomavirus ◽

High Risk ◽

Pap Test

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Adjunctive Human Papillomavirus DNA Testing Is a Useful Option in Some Clinical Settings for Disease Risk Assessment and Triage of Females With ASC-H Papanicolaou Test Results

Archives of Pathology & Laboratory Medicine ◽

10.5858/132.12.1874 ◽

2008 ◽

Vol 132 (12) ◽

pp. 1874-1881 ◽

Cited By ~ 3

Author(s):

Sudeshna Bandyopadhyay ◽

R. Marshall Austin ◽

David Dabbs ◽

Chengquan Zhao

Keyword(s):

Risk Assessment ◽

Human Papillomavirus ◽

High Risk ◽

Disease Risk ◽

Pap Test ◽

Intraepithelial Neoplasia ◽

Test Results ◽

Dna Testing ◽

High Risk Hpv

Abstract Context.—Recent guidelines recommend colposcopy for women with atypical squamous cells, cannot exclude high-grade squamous intraepithelial lesion (ASC-H). Objective.—To determine whether adjunctive high-risk human papillomavirus (hrHPV) testing is useful for disease risk assessment in females with ASC-H Papanicolaou (Pap) test results. Design.—High-risk HPV prevalence and histopathologic follow-up data on 1187 females with ASC-H ThinPrep Pap test (TPPT) and hrHPV test results were analyzed. Results.—ASC-H was reported in 1646 (0.006%) of 277 400 (270 338 TPPT and 7062 conventional) Pap test results. The difference in ASC-H detection rates between TPPTs and conventional Pap smears was statistically significant (0.60% vs 0.38%; P = .02). High-risk HPV was detected in 589 (49.6%) of 1187 females with ASC-H TPPT and hrHPV testing. The hrHPV DNA–positive rate in females younger than 40 years was 54.7%, significantly higher than the 36.5% in women 40 years and older. Among 505 females with histopathologic follow-up, cervical intraepithelial neoplasia 2/3 was identified in 32.7% of hrHPV-positive females compared with 1.2% in hrHPV-negative females. The sensitivity, specificity, positive predictive value, and negative predictive value of ASC-H cytology in conjunction with hrHPV DNA testing results for detection of cervical intraepithelial neoplasia 2/3 were 96.1% versus 100.0%, 54.0% versus 68.4%, 35.8% versus 20.8%, and 98.1% versus 100.0% in females younger than 40 years and women 40 years and older, respectively. Conclusions.—Our data suggest that reflex hrHPV testing is a highly useful option for women with ASC-H Pap tests. Females with ASC-H and negative hrHPV testing may be more efficiently managed by follow-up with regular Pap and hrHPV testing rather than universal colposcopy, especially for women 40 years and older.

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Hybrid Capture II Testing for High-Risk Human Papillomavirus DNA in the Follow-up of Women Treated for High-Grade Cervical Intraepithelial Neoplasia

Journal of Lower Genital Tract Disease ◽

10.1097/lgt.0b013e31826cd7c1 ◽

2013 ◽

Vol 17 (3) ◽

pp. 308-314 ◽

Cited By ~ 5

Author(s):

Jeffrey H.J. Tan ◽

Suzanne M. Garland ◽

Sepehr N. Tabrizi ◽

Elya E. Moore ◽

Jennifer A. Danielewski ◽

...

Keyword(s):

Human Papillomavirus ◽

High Risk ◽

Cervical Intraepithelial Neoplasia ◽

Intraepithelial Neoplasia ◽

High Grade ◽

Hybrid Capture ◽

Papillomavirus Dna

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Genome-Wide Association Study of Prevalent and Persistent Cervical High-Risk Human Papillomavirus(HPV) Infection

10.21203/rs.2.16987/v1 ◽

2019 ◽

Author(s):

Sally N. Adebamowo ◽

Adebowale A Adeyemo ◽

Charles N Rotimi ◽

Olayinka Olaniyan ◽

Richard B. Offiong ◽

...

Keyword(s):

Human Papillomavirus ◽

High Risk ◽

Association Study ◽

Genome Wide Association Study ◽

Principal Component ◽

Hpv Infection ◽

Genome Wide Association ◽

Replication Studies ◽

Genome Wide

Abstract Background: Genetic factors may influence the susceptibility to high-risk human papillomavirus (hrHPV) infection and persistence. We conducted the first genome-wide association study (GWAS) to identify variants associated with cervical hrHPV infection and persistence. Methods: Participants were 517 Nigerian women evaluated at baseline and 6 months follow-up visits for HPV. HPV was characterized using SPF10/LiPA25. hrHPV infection was positive if at least one carcinogenic HPV genotype was detected in a sample provided at the baseline visit and persistent if at least one carcinogenic HPV genotype was detected in each of the samples provided at the baseline and follow-up visits. Genotyping was done using the Illumina Multi-Ethnic Genotyping Array (MEGA) and imputation was done using the African Genome Resources Haplotype Reference Panel. Association analysis was done under additive genetic models adjusted for age, HIV status and the first principal component (PC) of the genotypes. Results: The mean (±SD) age of the study participants was 38 (±8) years, 48% were HIV negative, 24% were hrHPV positive and 10% had persistent hrHPV infections. The top three variants associated with hrHPV infections were intronic variants clustered in KLF12 (all OR: 7.06, p=1.43 x 10-6). The top variants associated with cervical hrHPV persistence were in DAP(OR: 6.86, p=7.15 x 10-8), NR5A2(OR: 3.65, p=2.03 x 10-7) and MIR365-2(OR: 7.71, p=2.63 x 10-7) gene regions. Conclusions: This exploratory GWAS yielded novel candidate risk loci for cervical hrHPV infection and persistence. The identified loci have biological annotation and functional data supporting their role in hrHPV infection and persistence. Given our limited sample size, larger discovery and replication studies are warranted to further characterize the reported associations.

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Colposcopy, cervical cytology and human papillomavirus detection as screening tools for cervical cancer

Eastern Mediterranean Health Journal ◽

10.26719/2001.7.1-2.100 ◽

2001 ◽

Vol 7 (1-2) ◽

pp. 100-105

Author(s):

Al Alwan Al Alwan

Keyword(s):

Human Papillomavirus ◽

High Risk ◽

Pap Test ◽

Screening Tools ◽

Low Grade ◽

Squamous Intraepithelial Lesions ◽

Sampling Device ◽

Squamous Cells ◽

The Bethesda System ◽

Intraepithelial Lesions

A cohort of 77 women referred for routine screening or investigation of Pap test abnormality underwent colposcopic examination. Pap-stained liquid-based preparations were diagnosed and categorized according to the Bethesda system. Residual material on the sampling device was used to detect high-risk oncogenic human papillomavirus DNA. Although the colposcopic failure rate was higher than that of cytology, no lesion was missed when both methods were used together. High-risk types were recorded in 24% of patients with atypical squamous cells of undetermined significance, 45% with low-grade squamous intraepithelial lesions and 79% with high-grade squamous intraepithelial lesions-indicating that the efficacy of cytological screening can be improved by papillomavirus detection.

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Prevalence, incidence, and distribution of human papillomavirus types in female sex workers in Kenya

International Journal of STD & AIDS ◽

10.1177/0956462419884454 ◽

2020 ◽

Vol 31 (2) ◽

pp. 109-118

Author(s):

Kristen Sweet ◽

Claire Bosire ◽

Busola Sanusi ◽

Carly J Sherrod ◽

Jessie Kwatampora ◽

...

Keyword(s):

Human Papillomavirus ◽

High Risk ◽

Sex Workers ◽

Female Sex Workers ◽

Sub Saharan Africa ◽

Hiv Positive ◽

Female Sex ◽

Hpv Prevalence ◽

Hiv Negative

Female sex workers (FSWs) have a notably high risk of acquiring human papillomavirus (HPV) infections. Relatively few studies address the type-specific prevalence and incidence of HPV among FSWs in sub-Saharan Africa. FSWs (n = 348) attending the Korogocho clinic in Nairobi, Kenya participated from August 2009 to March 2011. HPV DNA was detected using the SPF10-LiPA25 PCR assay. Baseline prevalence of HPV infection and cervical dysplasia were calculated, stratified by HIV-serostatus. Incidence rate (IR) of infection was calculated as number of new infections from baseline over person-months among 160 HPV-negative participants with complete 12-month follow-up. Baseline HPV prevalence was 23.6% for any HPV and 20.4% for high-risk HPV (hrHPV) types. Most prevalent types were HPV52 (10.1%), HPV35 (2.3%), and HPV51 (2.3%). A quarter (24%) of participants were HIV-positive. HPV prevalence was higher in HIV-positive (32.1%) than HIV-negative (20.8%) participants. hrHPV prevalence was higher in HIV-positive (27.4%) than HIV-negative (18.2%) women. During follow-up, HPV IR was 31.4 (95% CI: 23.8–41.5) for any HPV and 24.2 (95% CI: 17.9–32.8) for hrHPV types. HPV52 had the highest IR (6.0; 95% CI: 6.5–10.3). Overall HPV and hrHPV prevalence were lower than expected, but both prevalence and incidence were higher in HIV-positive than in HIV-negative women.

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Providing high quality information about human papillomavirus for women after treatment for high-grade cervical dysplasia

Sexual Health ◽

10.1071/sh09059 ◽

2010 ◽

Vol 7 (1) ◽

pp. 49 ◽

Cited By ~ 4

Author(s):

Suzanne Dyson ◽

Marian Pitts ◽

Anthony Lyons ◽

Robyn Mullins

Keyword(s):

Human Papillomavirus ◽

Information Needs ◽

Qualitative Interviews ◽

Cervical Dysplasia ◽

Pap Test ◽

Intraepithelial Neoplasia ◽

General Information ◽

High Grade ◽

Hpv Testing

Background: The present study aimed to inform the production of a resource for women who have had a high-grade cervical abnormality and are scheduled to undergo testing for human papillomavirus (HPV) at their 12-month follow-up. Methods: Two rounds of semi-structured, qualitative interviews were held with women who were attending a gynaecological oncology clinic at a major teaching hospital for women in Melbourne, Australia, 6 months after treatment for cervical intraepithelial neoplasia (CIN) to receive a follow-up Pap test and colposcopy. In an initial round of interviews, we gauged the reactions of 16 women to an existing information brochure containing general information about HPV. Based on the findings from the interviews, a second brochure aimed specifically for women scheduled to undergo HPV testing as part of their post treatment follow-up was drafted. Feedback was then gathered from a further 12 women. Results: While all participants had received some information and counselling about HPV and HPV testing as part of their treatment, many still experienced high levels of stress and anxiety about cancer and the sexually transmissible nature of HPV. Many also still had unanswered questions about HPV, their treatment regime and future prognosis. Conclusion: For a brochure to provide an effective adjunct to counselling, it is essential that it is carefully developed and pilot tested to ensure that it is easily understood and meets the information needs of the target audience. Such materials need to provide both medical and psychosocial information about HPV and be presented in accessible, easy to understand language.

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