BMJ  2006;332:83-85 (14 January), doi:10.1136/bmj.38701.440961.7C (published 6 January 2006)

Research

Effect of testing for human papillomavirus as a triage during screening for cervical cancer: observational before and after study

¹ Cancer Screening Evaluation Unit, Institute of Cancer Research, Sutton, Surrey SM2 5NG, ² Health Economics Research Centre, Department of Public Health, University of Oxford, Oxford OX3 7LF, ³ Unit of Health Care Epidemiology, Department of Public Health, University of Oxford, Oxford OX3 7LF, ⁴ NHS Cancer Screening Programmes, Sheffield S10 3TH, ⁵ University of Manchester, St Mary's Hospital, Manchester M13 0JH

Abstract

Objective To assess the effect of introducing testing for human papillomavirus combined with liquid based cytology in women with low grade cytological abnormalities.

Design Observational before and after study.

Setting Three cervical screening laboratories, England.

Participants 5654 women aged 20-64 with low grade cytological abnormalities found at routine cervical screening in a pilot; 5254 similar women in the period before the pilot.

Interventions Human papillomavirus testing combined with liquid based cytology in the management of women with borderline or mildly dyskaryotic cervical smear results compared with conventional smear tests, with immediate referral to colposcopy of women positive for human papillomavirus.

Results 57.9% (3187/5506) of women tested in the pilot were positive for human papillomavirus. The rate of repeat smears fell by 74%, but the rate of referral to colposcopy for low grade cytological abnormalities more than doubled. The estimated negative predictive value of human papillomavirus testing varied between 93.8% and 99.7%.

Conclusion The addition of testing for human papillomavirus in women with low grade cytological abnormalities resulted in a reduction in the rate of repeat smears, but an increase in rates of referral to colposcopy.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

Relevant Articles

When to test women for human papillomavirus: Testing is possible without increasing colposcopy referral rate

Johannes Berkhof, Folkert J van Kemenade, Peter J Snijders, René H Verheijen, and Chris J Meijer
BMJ 2006 332: 237. [Extract] [Full Text]

HPV triage could be cost effective
BMJ 2006 332: 0. [Full Text]

When to test women for human papillomavirus

Mark Schiffman and Philip E Castle
BMJ 2006 332: 61-62. [Extract] [Full Text] [PDF]

Lifetime effects, costs, and cost effectiveness of testing for human papillomavirus to manage low grade cytological abnormalities: results of the NHS pilot studies

Rosa Legood, Alastair Gray, Jane Wolstenholme, and Sue Moss
BMJ 2006 332: 79-85. [Abstract] [Full Text] [PDF]

This article has been cited by other articles:

• Goldsmith, M R, Austoker, J, Marsh, G, Kehoe, S T, Bankhead, C R (2008). Cervical screening result communication: a focus-group investigation of English women's experiences and needs. Qual Saf Health Care 17: 334-338 [Abstract] [Full text]  
• Monsonego, J., Pollini, G., Evrard, M. J., Sednaoui, P., Monfort, L., Quinzat, D., Dachez, R., Syrjanen, K. (2008). Linear array genotyping and hybrid capture II assay in detecting human papillomavirus genotypes in women referred for colposcopy due to abnormal Papanicolaou smear. Int J STD AIDS 19: 385-392 [Abstract] [Full text]  
• Berkhof, J., van Kemenade, F. J, Snijders, P. J, Verheijen, R. H, Meijer, C. J (2006). When to test women for human papillomavirus: Testing is possible without increasing colposcopy referral rate. BMJ 332: 237-237 [Full text]  
• Schiffman, M., Castle, P. E (2006). When to test women for human papillomavirus. BMJ 332: 61-62 [Full text]  

Rapid Responses:

Read all Rapid Responses

High-risk human papillomavirus testing for women with borderline or mild dyskaryosis without increasing the colposcopy referral rate

Johannes Berkhof, et al.
bmj.com, 19 Jan 2006 [Full text]

Online poll

Find out more >>