Reflex human papillomavirus test results as an option for the management of korean women with atypical squamous cells cannot exclude high-grade squamous intraepithelial lesion

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background. Currentguidelines recommend initial colposcopy with biopsy regardless of human papillomavirus (HPV) test results in women with atypical squamous cells, cannot exclude high-grade squamous intraepithelial lesion (ASC-H). The purpose of this study was to evaluate the value of HPV testing in women with ASC-H based on colposcopic pathology results. Materials and Methods. A multicenter cross-sectional study was carried out atthree academic hospitals and involved 40,847 Korean women who underwent cervical cancer screening with cytology and HPV tests with or without subsequent colposcopic biopsies between January 2007 and December 2013. Results. ASC-H was diagnosed in 276 women (0.7%). Only 6 of 68 (8.8%) women with ASC-H who were HPV negative had cervical intraepithelial neoplasia grade >2 (CIN >2) lesions, whereas 47.4% of the women with ASC-H who were HPV positive had CIN >2 lesions. No cases of invasive cervical cancer were diagnosed among women with ASC-H who were HPV negative. Logistic regression analysis was performed using the group with normal Papanicolaou test results and HPV-negative status as the reference group. Women with ASC-H who were HPV positive had a significantly increased risk of CIN >2 lesions, whereas no significant increase was observed in patients with ASC-H and HPV-negative status. Conclusion. If the result of the HPV test was negative, the risk of CIN >2 lesions in Korean women with ASC-H cytology was low. Reflex HPV testing should be an option for the management of women with cytology showing ASC-H to decrease unnecessary colposcopic biopsies, which are expensive and invasive.

Original languageEnglish
Pages (from-to)635-639
Number of pages5
JournalOncologist
Volume20
Issue number6
DOIs
Publication statusPublished - 2015 Jan 1

Fingerprint

Reflex
Cell Biology
Biopsy
Uterine Cervical Neoplasms
Squamous Intraepithelial Lesions of the Cervix
Atypical Squamous Cells of the Cervix
Papanicolaou Test
Colposcopy
Cervical Intraepithelial Neoplasia
Early Detection of Cancer
Cross-Sectional Studies
Logistic Models
Regression Analysis
Pathology

Keywords

  • Atypical squamous cells, Cannot exclude high-grade squamous intraepithelial lesion
  • Cervical cancer
  • Cervical intraepithelial neoplasia
  • Colposcopy
  • Human papillomavirus
  • Papanicolaou test

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

@article{bdec2f00ad884b48a076458e2e2ee480,
title = "Reflex human papillomavirus test results as an option for the management of korean women with atypical squamous cells cannot exclude high-grade squamous intraepithelial lesion",
abstract = "Background. Currentguidelines recommend initial colposcopy with biopsy regardless of human papillomavirus (HPV) test results in women with atypical squamous cells, cannot exclude high-grade squamous intraepithelial lesion (ASC-H). The purpose of this study was to evaluate the value of HPV testing in women with ASC-H based on colposcopic pathology results. Materials and Methods. A multicenter cross-sectional study was carried out atthree academic hospitals and involved 40,847 Korean women who underwent cervical cancer screening with cytology and HPV tests with or without subsequent colposcopic biopsies between January 2007 and December 2013. Results. ASC-H was diagnosed in 276 women (0.7{\%}). Only 6 of 68 (8.8{\%}) women with ASC-H who were HPV negative had cervical intraepithelial neoplasia grade >2 (CIN >2) lesions, whereas 47.4{\%} of the women with ASC-H who were HPV positive had CIN >2 lesions. No cases of invasive cervical cancer were diagnosed among women with ASC-H who were HPV negative. Logistic regression analysis was performed using the group with normal Papanicolaou test results and HPV-negative status as the reference group. Women with ASC-H who were HPV positive had a significantly increased risk of CIN >2 lesions, whereas no significant increase was observed in patients with ASC-H and HPV-negative status. Conclusion. If the result of the HPV test was negative, the risk of CIN >2 lesions in Korean women with ASC-H cytology was low. Reflex HPV testing should be an option for the management of women with cytology showing ASC-H to decrease unnecessary colposcopic biopsies, which are expensive and invasive.",
keywords = "Atypical squamous cells, Cannot exclude high-grade squamous intraepithelial lesion, Cervical cancer, Cervical intraepithelial neoplasia, Colposcopy, Human papillomavirus, Papanicolaou test",
author = "Ryu, {Ki Jin} and Sanghoon Lee and Min, {Kyung Jin} and Kim, {Jae Won} and Jin-Hwa Hong and Song, {Jae Yun} and Lee, {Jae Kwan} and Lee, {Nak Woo}",
year = "2015",
month = "1",
day = "1",
doi = "10.1634/theoncologist.2014-0459",
language = "English",
volume = "20",
pages = "635--639",
journal = "Oncologist",
issn = "1083-7159",
publisher = "AlphaMed Press",
number = "6",

}

TY - JOUR

T1 - Reflex human papillomavirus test results as an option for the management of korean women with atypical squamous cells cannot exclude high-grade squamous intraepithelial lesion

AU - Ryu, Ki Jin

AU - Lee, Sanghoon

AU - Min, Kyung Jin

AU - Kim, Jae Won

AU - Hong, Jin-Hwa

AU - Song, Jae Yun

AU - Lee, Jae Kwan

AU - Lee, Nak Woo

PY - 2015/1/1

Y1 - 2015/1/1

N2 - Background. Currentguidelines recommend initial colposcopy with biopsy regardless of human papillomavirus (HPV) test results in women with atypical squamous cells, cannot exclude high-grade squamous intraepithelial lesion (ASC-H). The purpose of this study was to evaluate the value of HPV testing in women with ASC-H based on colposcopic pathology results. Materials and Methods. A multicenter cross-sectional study was carried out atthree academic hospitals and involved 40,847 Korean women who underwent cervical cancer screening with cytology and HPV tests with or without subsequent colposcopic biopsies between January 2007 and December 2013. Results. ASC-H was diagnosed in 276 women (0.7%). Only 6 of 68 (8.8%) women with ASC-H who were HPV negative had cervical intraepithelial neoplasia grade >2 (CIN >2) lesions, whereas 47.4% of the women with ASC-H who were HPV positive had CIN >2 lesions. No cases of invasive cervical cancer were diagnosed among women with ASC-H who were HPV negative. Logistic regression analysis was performed using the group with normal Papanicolaou test results and HPV-negative status as the reference group. Women with ASC-H who were HPV positive had a significantly increased risk of CIN >2 lesions, whereas no significant increase was observed in patients with ASC-H and HPV-negative status. Conclusion. If the result of the HPV test was negative, the risk of CIN >2 lesions in Korean women with ASC-H cytology was low. Reflex HPV testing should be an option for the management of women with cytology showing ASC-H to decrease unnecessary colposcopic biopsies, which are expensive and invasive.

AB - Background. Currentguidelines recommend initial colposcopy with biopsy regardless of human papillomavirus (HPV) test results in women with atypical squamous cells, cannot exclude high-grade squamous intraepithelial lesion (ASC-H). The purpose of this study was to evaluate the value of HPV testing in women with ASC-H based on colposcopic pathology results. Materials and Methods. A multicenter cross-sectional study was carried out atthree academic hospitals and involved 40,847 Korean women who underwent cervical cancer screening with cytology and HPV tests with or without subsequent colposcopic biopsies between January 2007 and December 2013. Results. ASC-H was diagnosed in 276 women (0.7%). Only 6 of 68 (8.8%) women with ASC-H who were HPV negative had cervical intraepithelial neoplasia grade >2 (CIN >2) lesions, whereas 47.4% of the women with ASC-H who were HPV positive had CIN >2 lesions. No cases of invasive cervical cancer were diagnosed among women with ASC-H who were HPV negative. Logistic regression analysis was performed using the group with normal Papanicolaou test results and HPV-negative status as the reference group. Women with ASC-H who were HPV positive had a significantly increased risk of CIN >2 lesions, whereas no significant increase was observed in patients with ASC-H and HPV-negative status. Conclusion. If the result of the HPV test was negative, the risk of CIN >2 lesions in Korean women with ASC-H cytology was low. Reflex HPV testing should be an option for the management of women with cytology showing ASC-H to decrease unnecessary colposcopic biopsies, which are expensive and invasive.

KW - Atypical squamous cells, Cannot exclude high-grade squamous intraepithelial lesion

KW - Cervical cancer

KW - Cervical intraepithelial neoplasia

KW - Colposcopy

KW - Human papillomavirus

KW - Papanicolaou test

UR - http://www.scopus.com/inward/record.url?scp=84932649369&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84932649369&partnerID=8YFLogxK

U2 - 10.1634/theoncologist.2014-0459

DO - 10.1634/theoncologist.2014-0459

M3 - Article

C2 - 25964305

AN - SCOPUS:84932649369

VL - 20

SP - 635

EP - 639

JO - Oncologist

JF - Oncologist

SN - 1083-7159

IS - 6

ER -