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Saturday, December 14, 2013

Trailers (68): Low-risk HPV and cervical neoplasia

Thomsen, et al. High-risk and low-risk human papillomavirus and the absolute risk of cervical intraepithelial neoplasia or cancer

Why should you read about this topic?

To understand whether there is any benefit of testing for low-risk HPV in the context of cervical cancer screening.

What were the authors trying to do?

Estimate the risk of CIN 3 or worse in women with low-risk HPV but not high-risk HPV on cervical cytology

Who participated and in what setting?

Women (N=35,539) screened for cervical cancer in Copenhagen between 2002-5

What was the study design?

Prospective cohort, with identification of low-risk HPV (types 6, 11, 42, 43, and 44) DNA with the Hybrid Capture 2 test.

What were the main outcome measures?

CIN 3 or worse on cervical biopsies

What were the results?

Having low-risk HPV in the baseline screening sample did not alter the risk for CIN 3 or worse for women with positive or negative high-risk HPV test results.  The 8-year absolute risk of CIN3 or worse after a negative high-risk HPV and positive or negative low-risk HPV was lower than after normal cytology result, regardless of age. 

What is the most interesting image in the paper?

Figure 2

What were the study strengths and weaknesses?

Strengths: prospective; large number of participants; long follow-up.  Weaknesses: follow-up with Danish registries (Pathology Data Bank); no pathology review

What does the study contribute for your practice?

Don’t use low-risk HPV testing for cervical cancer screening