Human Papillomavirus testing for the management of low-grade cervical abnormalities in the UK—Influence of age and testing strategy

Abstract 

Background

The results of the UK pilot studies were encouraging with respect to the introduction of Human Papillomavirus (HPV) testing as a means to improve the management of low-grade cytological abnormalities. However, several important unresolved issues related to HPV triage remain, two of which are: what type of HPV test should be used and what age group should be targeted.

Objectives

To perform an evaluation of two commercial HPV detection tests and to correlate disease persistence and clearance with age and HPV status by the two tests.

Study design

We performed an evaluation of two commercial HPV tests in a cross-sectional analysis of 322 cervical cytology specimens with low-grade abnormalities. A subset of these specimens were then examined longitudinally, in order to correlate disease persistence and clearance with age and HPV status by the two detection tests.

Results

The two tests performed similarly with respect to the longitudinal identification/prediction of high-grade cervical disease. Age did not appear to be a factor in determining which cases went on to manifest high-grade disease within 3 years of a low-grade result (p=0.678).

Conclusions

This study weakens the case for age-adjusted HPV triage of low-grade cervical abnormalities.

Abbreviations: HR-HPV, high-risk Human Papillomavirus, CIN, cervical intraepithelial neoplasia, ASCUS, atypical squamous cells of undetermined significance, LBC, liquid based cytology

Keywords: HPV testing, Low-grade cervical cytology, Age