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Performance of Pap smear and human papilloma virus testing in the follow-up of women with cervical intraepithelial neoplasia grade 1 managed conservatively
| Content Provider | Scilit |
|---|---|
| Author | Santos, André Luis Ferreira Derchain, Sophie Françoise Mauricette Sarian, Luis Otávio Martins, Marcos Roberto Morais, Sirlei Siani Syrjänen, Kari Juhani |
| Copyright Year | 2006 |
| Description | Journal: Acta Obstetricia et Gynecologica Scandinavica Background. Conservative management (follow-up) of cervical intraepithelial neoplasia grade 1 (CIN1) is acceptable, but evidence on performance of follow-up tools, such as Pap smear and human papilloma virus (HPV) test, is still needed. Methods. A cohort of 78 women with histologically confirmed CIN1, referred because of atypical squamous cell or low-grade squamous intraepithelial lesion in their Pap smear, was enrolled between August 2000 and September 2002 and was prospectively followed-up at 6 and 12 months, until September 2003. Follow-up examinations included Pap test and Hybrid Capture II (HCII) with high-risk HPV, colposcopy, and cervical biopsies in patients with persistent abnormalities. Odds ratios and performance indicators (with 95% confidence interval) were calculated for HPV and Pap test results in detecting biopsy-confirmed CIN during the follow-up. Results. Thirty-seven (47%) of the women were HPV-positive at baseline. At first follow-up visit, 30 women had persistent CIN1 and one woman progressed to CIN2; 15 patients had CIN1 and one patient CIN2 at the second follow-up visit. Women with persistent CIN1 (or progression) during follow-up had a significantly higher HPV detection rate and abnormal Pap tests, compared to women with regressive disease. Cytology had a far better sensitivity in detecting CIN than HCII at the first follow-up visit (81 versus 52%, respectively), whereas both examinations had equivalent sensitivities at the second follow-up visit (69 and 56%, respectively). Cytology had a superior negative predictive value at the first follow-up visit and better positive predictive value, in addition, at the second visit. Conclusions. Because cytological abnormalities correlated generally better with the persistence of biopsy-confirmed CIN1 in this follow-up protocol, HCII test is the second-hand option to Pap test, but the use of both Pap and HCII together seems an unnecessary waste of resources. |
| Ending Page | 450 |
| Starting Page | 444 |
| ISSN | 00221295 |
| e-ISSN | 16000412 |
| DOI | 10.1080/00016340600604682 |
| Journal | Acta Obstetricia et Gynecologica Scandinavica |
| Issue Number | 4 |
| Volume Number | 85 |
| Language | English |
| Publisher | Wiley-Blackwell |
| Publisher Date | 2006-01-01 |
| Access Restriction | Open |
| Subject Keyword | Journal: Acta Obstetricia et Gynecologica Scandinavica Obstetrics and Gynecology Low-grade Cervical Intraepithelial Neoplasia |
| Content Type | Text |
| Resource Type | Article |
| Subject | Obstetrics and Gynecology |
