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Cancer Epidemiol Biomarkers Prev. 2010 Jul;19(7):1668-74. doi: 10.1158/1055-9965.EPI-09-1286.

Comparison of measurements of human papillomavirus persistence for postcolposcopic surveillance for cervical precancerous lesions.

Author information

1
Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 6120 Executive Boulevard, EPS/7013, Rockville, MD 20852, USA. gagej@mail.nih.gov

Abstract

OBJECTIVE:

Following guidelines, women evaluated by colposcopy, but not found to have a precancerous lesion, could be tested again at 12 months for carcinogenic human papillomavirus (HPV). Compared with pooled-probe testing, measuring HPV genotype-specific persistence might better predict subsequent grade 3 cervical intraepithelial neoplasia (CIN3).

METHODS:

For women enrolled in the immediate colposcopy arm of the Atypical squamous cells of undetermined significance (ASCUS) and Low-grade squamous intraepithelial lesion (LSIL) Triage Study (ALTS), who underwent enrollment colposcopy but were without prevalently detected CIN2 or worse (CIN2+; n = 671), we compared 1-year HPV persistence, as measured by a pooled HPV genotype test (hybrid capture 2; hc2) versus a research PCR HPV genotyping test (line blot assay; LBA) as predictors of "missed prevalent" or possibly incident CIN3 diagnosed between 12 and 24 months.

RESULTS:

Thirty-two (4.8%) women were diagnosed with subsequent CIN3. Testing repeatedly hc2-positive (hc2+) was more common (49.0%) than genotype-specific persistence as detected by LBA (30.3%, P < 0.01). Although absolute risks of CIN3 following repeat hc2+ or genotype-specific persistence were similar (8.8% versus 8.4%, P = 0.86), repeat hc2+ was more sensitive for identifying CIN3 than genotype-specific persistence (90.6% versus 53.1%, P < 0.01). Among 329 women repeatedly hc2+, women with persistent HPV16 were at higher risk of CIN3 than non-HPV16-persistent women (23.1% versus 7.0%, P < 0.01).

CONCLUSIONS:

For postcolposcopy management, 1-year HPV persistence as measured by hc2 would recall more women but was more sensitive and similarly predictive for CIN3 in the following year than detection of genotype-specific persistence by LBA.

IMPACT:

Although find little utility for measuring type-specific persistence, testing for persistent HPV16 might be clinically useful.

PMID:
20615884
PMCID:
PMC2919053
DOI:
10.1158/1055-9965.EPI-09-1286
[Indexed for MEDLINE]
Free PMC Article
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