BMJ  2006;332:237 (28 January), doi:10.1136/bmj.332.7535.237

Letter

When to test women for human papillomavirus

Testing is possible without increasing colposcopy referral rate

The first 150 words of the full text of this article appear below.

Editor—Moss et al show that colposcopy referral rates double if women with equivocal or mild cytological abnormality are referred for immediate colposcopy when human papillomavirus (HPV) is present in the first abnormal smear.1 Their colposcopy rates in women aged 35-64 seem to contradict those observed in the Netherlands.

We computed colposcopy referral rates in the Netherlands from data collected in the two armed POBASCAM screening trial.2 Women of 30-60 with borderline or mild dyskaryosis were recalled at 6 and 18 months and referred for colposcopy on the basis of repeat cytology according to current Dutch guidelines (control group) or on the basis of both repeat cytology and high risk HPV testing (intervention group).

In the control group 18.9% of all women with borderline dyskaryosis at baseline and 51.0% of those with mild dyskaryosis were eventually referred for colposcopy. After correction for loss to follow-up, we obtained adjusted colposcopy rates of . . . [Full text of this article]

Johannes Berkhof, assistant professor

Department of Clinical Epidemiology and Biostatistics, VU University Medical Centre, 1007 MB Amsterdam, Netherlands h.berkhof@vumc.nl

Folkert J van Kemenade, PhD, Peter J Snijders, PhD, René H Verheijen, professor, Chris J Meijer, professor

Department of Clinical Epidemiology and Biostatistics, VU University Medical Centre, 1007 MB Amsterdam, Netherlands


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Relevant Article

Effect of testing for human papillomavirus as a triage during screening for cervical cancer: observational before and after study
Sue Moss, Alastair Gray, Rosa Legood, Martin Vessey, Julietta Patnick, Henry Kitchener Liquid Based Cytology/Human Papillomavirus Cervical Pilot Studies Group
BMJ 2006 332: 83-85. [Abstract] [Full Text] [PDF]

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