Cervical Cytology and HPV Testing

Meta-analysis of ASCUS-HPV Triage Studies

March 2010

There have been a number of studies which have looked at the use of HPV testing in ASC-US Pap smears for a triage of these patients to colposcopy. A large meta-analysis of these studies has shown that using HPV testing works very well in ASC-US cytology and will separate out the two populations, one of which should go onto colposcopy and one of which can be followed with routine cytology follow-up.

Using a disease threshold of CIN2+ using HPV testing in ASC-US cases yields a sensitivity of approximately 94% with a range of 80%-100% for CIN2 with a reasonable specificity again ranging from 37%-80%. The specificity is lower again because HPV infection does not necessarily correlate with a CIN2 diagnosis.

Studies that have looked at repeat cytology as an indication for colposcopic examination show that using HPV testing yields a significantly higher sensitivity for CIN2+ with essentially equal specificity. These studies show that using HPV testing is a very good method to determine which women need to go on for a colposcopic examination.

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Jump to section:

• Introduction
• Anogenital HPV Types¹
• Mechanism for Transformation
• Natural History of HPV Infections²
• HPV DNA Testing in Cervical Specimens: Uses
• Meta-analysis of ASCUS-HPV Triage Studies³
• 2006 Consensus Guidelines-ASC-US
• 2006 Consensus Guidelines-ASC-US
• 2006 ASCCP Guidelines and CETC Recommendations
• 2006 Consensus Guidelines for ASC-US: Special Circumstances
• High-Risk HPV Testing⁵
• Low-Risk HPV Testing
• References
• Questions?