High-risk HPV DNA detected in less than 2% of over 25,000 cytology negative imaged liquid-based Pap test samples from women 30 and older

Abstract

Objective: The purpose of this study was to document the prevalence of high-risk HPV DNA (HPV) in the largest cohort of woman studied to date with negative ThinPrep Imaging system (TIS)-imaged Pap tests.

Methods: Women with negative (TIS)-imaged ThinPrep Pap Tests (TPPT) who also were tested for HPV were identified between July 1, 2005 and December 31, 2007 from a large women's hospital practice. HPV detection rates were compared for women with either presence or absence of a transformation zone/endocervical cell sample (EC/TZS).

Results: 26,558 negative TPPT also underwent HPV testing. HPV detection was higher in women younger than 30 and sharply declined in women 30-39 (P<0.001). Declining HPV detection rates continued in the 40-49 age group (age 30-39 vs. 40-49; 2.8% vs. 1.7%, P<0.001) and then levelled off. No statistically significant difference for HPV prevalence was identified comparing women with and without a TZ/ECS.

Conclusion: This is the largest study to date documenting very low HPV detection rates in women screened cytology negative with computer-imaged liquid-based Pap methods now representing a major portion of the U.S. cervical cytology market. Findings of very low rates of HPV detection in 490 (1.9%) of 25,259 cytology negative women 30 and older extend and confirm previously reported findings in smaller study populations. Because HPV testing provides an objective measure of relative residual risk for cervical neoplasia after screening, these data are relevant to discussions on how best to combine cytology and HPV testing in screening low risk populations.