Abstract
Objective. Atypical squamous cells of undetermined significance (ASCUS) cells, occurring in organized cytological screening, may be either high-risk human papillomavirus (HPV) positive or negative. To refine the assessment of women with ASCUS, a high-risk HPV-DNA test is recommended as triage in Sweden. Methods. A total of 197 consecutive women (mean age 39 years, range 21–60) with a diagnosis of ASCUS from the primary screening were selected for triage. Their cervical smears were collected and evaluated by using conventional cytological examination in combination with a high-risk HPV-DNA test (hybrid capture 2). The women were categorized into four groups: Group A, Cytology + /HPV + ; Group B, Cytology–/HPV + ; Group C, Cytology + /HPV–; and Group D, Cytology–/ HPV–. Women within Groups A–C were admitted for colposcopy and cervical biopsy. The women in Group D were considered as a low-risk group for tumor development, and were re-examined after three years in the next round of the organized screening. Results. In women in Group A (n=58) the prevalence of histological verified CIN2–3 was 41%, in Group B (n=41) 20%, and in Group C (n=9) 0%. In Group D (n=89), repeated primary screening three years later revealed CIN2–3 in two biopsies from 74 women studied (<3%). The prevalence of a high-risk HPV infection decreased with age in women with ASCUS. It was 74% in women <30 years and 19% in women ≥50 years. Conclusions. Adding a high-risk HPV test in secondary screening increased the identification of women with CIN2–3 lesions by 33% in comparison with repeat cytology (p=0.01). The clinical significance of the ASCUS diagnosis varied with age of the women.
| Abbreviations | ||
| ASCUS | = | atypical squamous cells of undetermined significance |
| CIN | = | cervical intraepithelial neoplasia |
| hc2 | = | hybrid capture 2 |
| HPV | = | human papillomavirus |
| Abbreviations | ||
| ASCUS | = | atypical squamous cells of undetermined significance |
| CIN | = | cervical intraepithelial neoplasia |
| hc2 | = | hybrid capture 2 |
| HPV | = | human papillomavirus |