Poor Sensitivity of HPV Type 16/18 in Abnormal Cytology
HPV 16/18 testing to triage women is poorly sensitive in minor abnormal cytology.
HealthDay News—Testing for human papillomavirus (HPV) 16/18 has poor sensitivity for triaging women with minor abnormal cytology, according to a meta-analysis published online in the Annals of Internal Medicine.1
Marc Arbyn, MD, from the Scientific Institute of Public Health in Brussels, and colleagues conducted a systematic literature review to examine the accuracy of genotyping for HPV types 16 and 18. Data were included for 24 moderate-to-good quality studies, involving 8,587 women with atypical squamous cells of undetermined significance (ASC-US) and 5,284 with low-grade squamous intraepithelial lesions (LSIL) who were triaged with tests for high-risk HPV (hrHPV) and HPV 16/18 to detect cervical intraepithelial neoplasia (CIN).
The researchers found that for women with either ASC-US or LSIL the pooled sensitivity of HPV 16/18 genotyping for CIN3+ was about 70%. With a threshold of grade <2 CIN, the pooled specificities were 83% and 76%, respectively, for women with ASC-US and LSIL. In HPV 16/18-positive women with ASC-US and LSIL, the average risk for CIN3+ was 17% and 19%, respectively, and was 5% in hrHPV-positive but HPV 16/18-negative women with ASC-US or LSIL.
"Testing for HPV 16/18 to triage women with minor abnormal cytology is poorly sensitive but may be useful as a second triage test after hrHPV testing, with direct referral if the woman is positive for HPV 16/18," the authors write.
Several authors disclosed financial ties to the biopharmaceutical industry.
- Arbyn M, Xu L, Verdoodt F, et al. Genotyping for human papillomavirus types 16 and 18 in women with minor cervical lesions: a systematic review and meta-analysis. Ann Intern Med. 2016. doi: 10.7326/M15-2735