When women with human papilloma virus (HPV) have low-grade cytology findings but a normal colposcopy, they can be followed at routine intervals, a UK team has shown.
Such women are at low risk for high-grade cervical intraepithelial neoplasia (CIN), the researchers say.
Most studies evaluating the risk of high-grade disease after a negative colposcopy were conducted before HPV testing. “Consequently women who are HPV-positive but colposcopy negative represent an interesting subgroup that merits further investigation,” said Dr. Sue Moss, with the Institute of Cancer Research in Sutton, Surrey and her colleagues in a new paper.
As reported online May31st in BJOG, the researchers reviewed data from pilot studies that had evaluated the strategy of triaging women with borderline or mild dyskaryosis for colposcopic examination on the basis of a positive HPV test. The current study focuses on a subset of 1063 women who were HPV-positive but negative at colposcopy.
The cumulative rates of CIN2 or worse at 1, 2, 3 and >3 years after negative colposcopy were 1.7%, 3.7%, 4.4% and 5.3%, respectively, according to the report.
“At each time-point the rate of CIN2+ and CIN3 was higher in women aged 35-64 years compared with those aged 20-34 years, but this was not statistically significant,” the investigators found.
Dr. Moss and colleagues comment that from both a psychological and economic standpoint, HPV-triaged women with negative colposcopy would best have cervical screening at the routine interval of every 3 years. “The risk of high-grade disease in this group at 3 years after a negative colposcopy is sufficiently low to permit this,” they conclude.
— Reuters Health Information0