Cervicography and HPV DNA testing as triage criteria for patients with abnormal Pap smear

Silvano Costa, Mario Sideri, Lauro Bucchi, Francesco Schettino, Isabella Maini, Laura Spinaci, Luciano Bovicelli, Patrizia Terzano

Research output: Contribution to journalArticle

Abstract

Cervicography and HPV DNA testing have been proposed as intermediate triage techniques for the management of patients with Pap smear showing minor-grade atypia. The aims of the present study of 221 patients with positive Pap smear (ages 16-65) were (1) to evaluate the association of cervicography and HPV DNA test with the probability of biopsy and final histology diagnosis of CIN2 or worse, (2) to identify the combinations of results on cervicography and HPV DNA test associated with the absence of such lesions, and (3) to estimate the cost of a potential triage protocol for patients with HPV-CIN1 smear. The probability of biopsy showed a univariate association with the severity of the smear result and the cervicography classification but not the HPV DNA test. In the multivariate analysis, only the cervicography result was a significant predictor of biopsy. The final histology diagnosis showed a univariate association with each of the three tests and a multivariate association with the degree of cytology positivity and the cervicography result. Among patients with HPV-CIN1 smears, only a negative cervicography (with any HPV DNA test result) was always associated with the absence of severe histologic lesions. This pattern accounted only for 7% of such patients. The additional costs of a potential triage protocol based on cervicography were estimated to exceed the savings resulting from the reduced colposcopy rate.

Original languageEnglish
Pages (from-to)404-409
Number of pages6
JournalGynecologic Oncology
Volume71
Issue number3
DOIs
Publication statusPublished - Dec 1998

ASJC Scopus subject areas

  • Obstetrics and Gynaecology
  • Oncology

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    Costa, S., Sideri, M., Bucchi, L., Schettino, F., Maini, I., Spinaci, L., Bovicelli, L., & Terzano, P. (1998). Cervicography and HPV DNA testing as triage criteria for patients with abnormal Pap smear. Gynecologic Oncology, 71(3), 404-409. https://doi.org/10.1006/gyno.1998.5183