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. 2009 Mar;113(3):595-600.
doi: 10.1097/AOG.0b013e3181996ffa.

Five-year experience of human papillomavirus DNA and Papanicolaou test cotesting

Philip E Castle  1 , Barbara Fetterman, Nancy Poitras, Thomas Lorey, Ruth Shaber, Walter Kinney
Affiliations

Five-year experience of human papillomavirus DNA and Papanicolaou test cotesting

Philip E Castle et al. Obstet Gynecol. 2009 Mar.

Abstract

Objective: To estimate the 5-year age group-specific test positives for Pap tests and human papillomavirus (HPV) testing in a large, general screening population of women 30 and older.

Methods: Using data from Kaiser Permanente Northern California, a large health maintenance organization that introduced cotesting in 2003, we evaluated the cotesting results overall and by 5-year age groups. Women (n=580,289) who opted for and underwent cotesting (n cotests=812,598) between January 2003 and April 2008 were included in the analysis. Pap tests interpreted as atypical squamous cells of undetermined significance (ASC-US) or more severe were considered to be positive. Women were tested for carcinogenic HPV using an assay approved by the U.S. Food and Drug Administration. Binomial exact 95% confidence intervals (CIs) were calculated.

Results: Overall, 6.27% (95% CI 6.21-6.32%) of cotests were carcinogenic HPV positive, and only 3.99% (95% CI 3.94-4.03%) cotests had normal cytology and were carcinogenic HPV positive. By comparison, 5.18% (95% CI 5.13-5.23%) of cotests had ASC-US or more severe cytology, and 2.87% (95% CI 2.84-2.91%) of cotests had ASC-US or more severe cytology and were carcinogenic HPV negative.

Conclusion: In a general screening population, concerns about excessive HPV test positives among women aged 30 years and older are not borne out.

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Figures

Figure 1
Figure 1
Percentage of woman with normal Papanicolaou (Pap) tests who tested positive for carcinogenic human papillomavirus (HPV) by Hybrid Capture 2 (hc2+) by age group (black squares) and for all women 30 and older (white squares). Data from the Kaiser Permanente Northern California Health Plan from January 2003 through April 2008.
See this image and copyright information in PMC

References

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