A comparison of the human papillomavirus test and Papanicolaou smear as a second screening method for women with minor cytological abnormalities

Authors: Andersson, Sonia1; Dillner, Lena2; Elfgren, Kristina1; Mints, Miriam1; Persson, Maria3; Rylander, Eva3

Source: Acta Obstetricia et Gynecologica Scandinavica, Volume 84, Number 10, October 2005 , pp. 996-1000(5)

Publisher: Informa Healthcare

Buy & download fulltext article:

The full text article is not available for purchase.

The publisher only permits individual articles to be downloaded by subscribers.

Abstract:

Background. 

Of the estimated one million Papanicolaou (pap) smears performed annually in Sweden, about 4% show any degree of abnormality. Approximately, 1% of these cases contain moderate or severe atypia (high-grade squamous intraepithelial lesions) and the rest contain low-grade atypia. Recommendations for the management of minor abnormalities vary in various parts of Sweden. Generally, a second Pap smear is obtained 4–6 months after the first one showing low-grade atypia. The aim of this study is to compare the sensitivity of human papilloma virus (HPV)-DNA testing for the detection of cervical intraepithelial neoplasia (CIN) 2–3 with that of a second Pap smear in women, who had low-grade atypia in their first Pap smear. Methods. 

Women with low-grade atypia in the Stockholm area, detected at a population-based cytology screening, were enrolled. A repeat Pap smear, HPV test, and colposcopically directed biopsies were obtained. For the detection of HPV, Hybrid Capture II (HC II) was used. Results. 

The HPV-DNA test was positive in 66% of the 177 participating women. The sensitivity of the second Pap smear and HPV-DNA test to detect CIN 2–3 was 61 (95% CI = 45–74) and 82% (95% CI = 67–91), respectively. The positive and negative predictive values of HPV testing were 27 (95% CI = 18–35) and 89% (95% CI = 80–97), respectively. Conclusions. 

In Sweden, a second Pap smear is often obtained for the follow-up of women with low-grade atypia. The results of our study show that compared to the second Pap smear, HPV testing with HC II is a more sensitive method for detecting high-grade lesions.

Keywords: CIN; HPV; Pap smear; screening

Document Type: Research Article

DOI: http://dx.doi.org/10.1111/j.0001-6349.2005.00702.x

Affiliations: 1: Division of Obstetrics and Gynecology, Institute for Clinical Science, Karolinska University Hospital, Huddinge, Karolinska Institute, Stockholm, 2: Department of Medical Microbiology, Lund University, University Hospital Malmö, and 3: Division of Obstetrics and Gynecology, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden

Publication date: October 1, 2005

More about this publication?
Related content

Key

Free Content
Free content
New Content
New content
Open Access Content
Open access content
Subscribed Content
Subscribed content
Free Trial Content
Free trial content

Text size:

A | A | A | A
Share this item with others: These icons link to social bookmarking sites where readers can share and discover new web pages. print icon Print this page