How would you treat these women?
The colposcopy fails to reveal any lesions.
What do the NHSCSP guidelines say to do?
NHSCSP suggests that women with borderline cytology (ASC-US) who are hrHPV+ be referred for colposcopy.1
HPV testing to triage borderline cytology (ASC-US) and low-grade dyskaryosis in women ≥25 years.
Absolute risk of ≥CIN2 according to genotype
Absolute risk of ≥CIN2 stratified by hrHPV status in the ATHENA NILM population2
Her prior cervical cytology was 4 years ago and was reported as negative. Her current cytology is also negative, but she requested a private HPV test and tested hrHPV+. What do the guidelines say?
ACOG, ASCCP, ASCP and ACS guidelines:3
Role of genotyping when screening5
ACOG, ASCCP, ASCP and ACS now recommend that in women 30-65 years of age, individual genotyping for HPV 16 or HPV 16 and 18 be considered when women have a normal cytology screening result but have positive results on a test for “pooled” hrHPV types.
Absolute risk of high-grade cervical disease in women with normal cytology
The cobas® HPV Test enables adherence to the guidelines by providing pooled hrHPV results and identifies the individual presence of HPV 16 and HPV 18, the highest-risk genotypes.
Absolute risk of ≥CIN2 stratified by hrHPV status in the ATHENA ASC-US population6
1. American Society for Colposcopy and Cervical Pathology. HPV Genotyping Clinical Update. http://www.asccp.org/ConsensusGuidelinesHPVGenotypingClinicalUpdate/tabid/5963/Default.aspx. Accessed June 2011.
2. Stoler MH, Wright TC, Sharma A, et al. High-risk human papillomavirus testing in women with ASC-US cytology: results from the ATHENA HPV study. Am J Clin Pathol. 2011;135(3):468-475
3. The American Congress of Obstetricians and Gynecologists. ACOG Practice Bulletin. Clinical Management Guidelines for Obstetrician-Gynecologists: Screening for Cervical Cancer. November, 2012
4. Saslow D et al, Journal of Lower Genital Tract Disease, Volume 16, Number 3, 2012
5. Wright TC Jr, Stoler MH, Sharma A, Zhang G, Behrens CM, Wright TL. Evaluation of HPV-16 and HPV-18 genotyping for the triage of women with high-risk HPV+ cytology-negative results. Am J Clin Pathol. 2011;136:578-586