9) The study established the utility of an HPV genotyping lest to help stratify patient risk when used as a screening co-test with cytology for women age 30-plus (9) or as a triage test for ASC-US
cytology results in women 21 and older.
Reflex HPV testing has been common at MWH for many years, reflecting our center's participation as 1 of 4 clinical trial sites in ALTS, which helped establish reflex HPV testing of ASC-US
Pap tests as a standard US practice.
cytology > ASC-US
and any HPV: refer directly for colposcopy
While most of these findings are negative for high-grade disease, 15-20% of LSIL and 6-10% of ASC-US
will harbour high-grade disease.
Numerous studies have looked at the histologic/clinical outcome following an ASC-US
Pap test, in addition to the above-mentioned studies.
If this second cytologic testing is ASC-US
or greater, then colposcopy should be performed.
Thus HC-II helped to select patients for biopsy after ASC-US
and L-SIL diagnosis on cytology smears.
Reasons stated for offering HR-HPV testing to patients aged 20 years or younger with ASC-US
include clinician insistence, patient demands for the test, use of HPV results to resolve diagnostic dilemmas, and HPV test ordering out of habit on these patients.
patients with HRHPV infection are more likely to show dysplasia on biopsy.
These trials support a CE Mark with claims for 1) primary screening, 2) the triage of ASC-US
and LSIL cytology results, and 3) the management of HR-HPV positive results when the Pap test is negative.
If their LSIL rate is substantially lower than others in the laboratory, then review of that individual's ASC-US
rate and the rate of upgrades at sign-out by a pathologist of Pap Tests diagnosed as ASC-US
to LSIL can be monitored to investigate whether the cytotechnologist is under calling LSIL.
At present, HPV testing is cleared by the United States Food and Drug Administration (FDA) for triaging women who have ASC-US
on Pap testing.
HPV Testing for Detecting High-Grade Cervical Disease in the Triage of ASC-US
and LSIL Pap Cytology Results" shows that the interpretation of p16 cytology slides has the potential to provide a high sensitivity, with significantly higher specificity for the identification of high-grade CIN than High-risk Human Papillomavirus (HR-HPV) testing for the management of women with Pap cytology results categorized as ASC-US
(Atypical Squamous Cells of Undetermined Significance) or LSIL (Low-grade Squamous Intraepithelial Lesion).
5%, 197 of 315), but some also include ASC-US
(39%, 123 of 315), ASC-H (31.
In a symposium of the College of American Pathologists' HPV meeting in Chicago in September 2002, information was presented showing that the most efficacious application of HPV DNA testing is for triage of women who have abnormal thin layer preparation cervical cytology diagnosed as ASC-US