Poor Sensitivity of HPV Type 16/18 in 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.

Reference

1. 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