Testing for high risk human papilloma virus in the initial follow-up of women treated for high-grade squamous intraepithelial lesions
Article first published online: 17 MAR 2010
© 2010 The Authors. Journal compilation © 2010 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists
Australian and New Zealand Journal of Obstetrics and Gynaecology
Volume 50, Issue 2, pages 164–167, April 2010
How to Cite
SMART, O. C., SYKES, P., MACNAB, H. and JENNINGS, L. (2010), Testing for high risk human papilloma virus in the initial follow-up of women treated for high-grade squamous intraepithelial lesions. Australian and New Zealand Journal of Obstetrics and Gynaecology, 50: 164–167. doi: 10.1111/j.1479-828X.2009.01132.x
- Issue published online: 13 APR 2010
- Article first published online: 17 MAR 2010
- Received 16 September 2009; accepted 3 December 2009.
- cervical cytology;
- cervical intraepithelial neoplasia;
- human papilloma virus
Background: The follow-up schedule of women who have undergone treatment for high grade squamous intraepithelial lesions (HSIL) is a crucial part of the cervical screening programme. The ability to detect residual disease or early recurrence enables the provision of timely secondary intervention.
Aims: The aim of this study was to determine the prevalence of High Risk HPV and cytological abnormalities at first follow-up visit post treatment. The feasibility, safety and cost benefit of omitting routine colposcopy as a first line investigation were evaluated.
Methods: A total of 100 women with histologically confirmed and treated HSIL were recruited prior to first follow-up visit. Colposcopic assessment, cervical cytology using LBC and HR HPV testing was carried out on all women.
Results: In all, 75% of the study group had both a negative HR HPV test and a normal cervical cytology at first follow-up visit. Mean time interval to first follow-up was 9 months. The rate of residual/recurrent high-grade disease within this cohort was 4% followed up to 18 months post treatment. HR HPV had a sensitivity of 100% to detect persistent HSIL.
Conclusion: High-risk human papilloma virus testing in combination with cytology at first follow-up visit in women treated for HSIL has a very high sensitivity and negative predictive value. Colposcopy does not improve specificity in this cohort and could be omitted in patients who have a negative smear and HPV test.