1. Detection of cervical precancer and cancer in a hospital population; benefits of testing for human papillomavirus
- Author
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V, Dalstein, D, Riethmuller, J L, Sautière, J L, Prétet, B, Kantelip, J P, Schaal, and C, Mougin
- Subjects
Adult ,Aged, 80 and over ,Vaginal Smears ,Adolescent ,Papillomavirus Infections ,Uterine Cervical Neoplasms ,Middle Aged ,Uterine Cervical Dysplasia ,Sensitivity and Specificity ,Hospitalization ,Tumor Virus Infections ,Colposcopy ,DNA, Viral ,Humans ,Mass Screening ,Female ,Papillomaviridae ,Precancerous Conditions ,Aged ,Follow-Up Studies ,Papanicolaou Test - Abstract
The aim was to determine the relevance of human papillomavirus (HPV) testing in identifying high-grade cervical intraepithelial neoplasia or worse (CIN2/3+) in a hospital population (n=3574) characterised by a high rate of cytological abnormalities and high-risk HPV infections. According to the results of the initial Papanicolaou and HPV test, women were directly referred for colposcopy/biopsy or recalled for a control visit. Sensitivity and specificity were corrected for verification bias. HPV-testing sensitivity was 94.3%, higher than that of cytological testing at any cut-off point (65.1%-86.8%), while specificity was greater for cytology than for HPV testing (99.3% or 91.8% versus 83.4%). The combination of both tests allowed 100% sensitivity and negative predictive value. We conclude that HPV testing is a relevant tool for the detection of cervical disease. The best way of combining cytology and HPV detection in screening programmes should be evaluated in large-scale studies.
- Published
- 2003