Test positivity cutoff level of a high risk human papillomavirus test could be increased in routine cervical cancer screening†
Version of Record online: 12 SEP 2008
Copyright © 2008 Wiley-Liss, Inc.
International Journal of Cancer
Volume 123, Issue 12, pages 2902–2906, 15 December 2008
How to Cite
Kotaniemi-Talonen, L., Malila, N., Nieminen, P., Anttila, A., Tarkkanen, J., Laurila, P. and Hakama, M. (2008), Test positivity cutoff level of a high risk human papillomavirus test could be increased in routine cervical cancer screening. Int. J. Cancer, 123: 2902–2906. doi: 10.1002/ijc.23839
PN has worked as a consultant for MSD Ltd. and GSK Ltd. Other authors declare they have no conflict of interest.
- Issue online: 15 OCT 2008
- Version of Record online: 12 SEP 2008
- Manuscript Accepted: 23 JUN 2008
- Manuscript Received: 24 APR 2008
- European Union Action Programme Europe Against Cancer
- Academy of Finland and Finnish Cancer Organisations
- cervical cancer;
- routine screening;
- HPV DNA testing;
- Hybrid Capture 2;
- rlu ratio
We present data on test positivity, relative sensitivity, rates of detection and relative specificity for primary human papillomavirus (HPV) testing with different cutoff levels for test positivity, in comparison to conventional cytology. In 2003–2004, 18,438 women were screened primarily with Hybrid Capture 2 (HC 2) assay, a test for oncogenic HPV DNA, and 21,446 with conventional cytology within the organised screening programme in Finland. A cytological triage test was performed for the HPV positives. Women with cytology equal to low grade squamous intraepithelial lesion (LSIL) or worse were referred for colposcopy. The relative sensitivity measured as relative risk (RR) of any cervical intraepithelial neoplasia (CIN) or cancer was 1.58 for the HPV test at the relative light units (rlu) ratio cutoff 1.00, in comparison to cytology. With the cutoff 3.00, all CIN 2+ lesions were detected. With cutoff 10.00, 2 of the 22 CIN 3+ lesions were missed. Relative specificity for HPV screening for any CIN was 92.6% at cutoff 1.00, 94.6% at cutoff 3.00 and 96.3% at cutoff 10.00. For CIN 3+ specificity estimates for these cutoffs were 92.1%, 94.1% and 95.8%, respectively. Used for routine screening as the sole test, the HPV test cutoff can be increased from the level recommended for clinical use. With HC 2, the detection rate at rlu ratio cutoff 10.00 is still at the level of high-quality conventional screening. At that level, the false positive rate is reduced by about half and the specificity of the HPV test becomes equal to the average specificity of conventional cytology. © 2008 Wiley-Liss, Inc.