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Interim Guidance for the Use of Human Papillomavirus DNA Testing as an Adjunct to Cervical Cytology for Screening

Wright, Thomas C. Jr MD; Schiffman, Mark MD, MPH; Solomon, Diane MD; Cox, J Thomas MD; Garcia, Francisco MD, MPH; Goldie, Sue MD, MPH; Hatch, Kenneth MD; Noller, Kenneth L. MD; Roach, Nancy; Runowicz, Carolyn MD; Saslow, Debbie PhD

doi: 10.1097/01.AOG.0000109426.82624.f8
Current Commentary
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Human papillomavirus (HPV) DNA testing was recently approved by the Food and Drug Administration for use as an adjunct to cytology for cervical cancer screening. To help provide guidance to clinicians and patients when using HPV DNA testing as an adjunct to cervical cytology for screening, a workshop was cosponsored by the National Institutes of Health–National Cancer Institute, American Society of Colposcopy and Cervical Pathology (ASCCP), and American Cancer Society. Consensus was reached based on a literature review, expert opinion, and unpublished results from large ongoing screening studies. The conclusions of the workshop were that HPV DNA testing may be added to cervical cytology for screening in women aged 30 years or more. Women whose results are negative by both HPV DNA testing and cytology should not be rescreened before 3 years. Women whose results are negative by cytology, but are high-risk HPV DNA positive, are at a relatively low risk of having high-grade cervical neoplasia, and colposcopy should not be performed routinely in this setting. Instead, HPV DNA testing along with cervical cytology should be repeated in these women at 6 to 12 months. If test results of either are abnormal, colposcopy should then be performed. This guidance should assist clinicians in utilizing HPV DNA testing in an effective manner, while minimizing unnecessary evaluations and treatments.

Human papillomavirus DNA–positive women with negative cervical cytology results should be retested in 6 to 12 months rather than referred for colposcopy.

Department of Pathology, College of Physicians and Surgeons of Columbia University, New York, New York; National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland; Student Health Services, University of California at Santa Barbara, Santa Barbara, California; Department of Obstetrics and Gynecology, University of Arizona, Arizona Cancer Center, Tucson, Arizona; Harvard Center for Risk Analysis, Harvard School of Public Health, Boston, Massachusetts; Department of Obstetrics and Gynecology, Tufts University and New England Medical Center, Boston, Massachusetts; Marti Nelson Cancer Foundation, Hood River, Oregon; University of Connecticut School of Medicine, Farmington, Connecticut; and American Cancer Society, Atlanta, Georgia

Received July 28, 2003. Received in revised form September 25, 2003. Accepted October 2, 2003.

The workshop was supported by funding from the National Institutes of Health–National Cancer Institute, American Society of Colposcopy and Cervical Pathology (ASCCP), and the American Cancer Society. The views expressed in this document do not represent the official positions of the organizations to which the workshop participants belong.

Address correspondence to: Thomas C. Wright Jr, MD, Room 16-404, P&S Building, 630 West 168th Street, New York, NY 10032; e-mail: tcw1@columbia.edu.

© 2004 The American College of Obstetricians and Gynecologists