Immediate histologic correlation in women with atypical squamous cells of undetermined significance cytology and positive high‐risk HPV: A retrospective review of 6000 cases in a large academic women's hospital
Background
Previous studies of the histologic correlation in women who have atypical squamous cells of undetermined significance cytology (ASC‐US) and are positive for high‐risk human papillomavirus (hrHPV+) have predominantly utilized the Hybrid Capture 2 (HC2) test, whereas the use of other US Food and Drug Administration (FDA)‐approved methods is relatively limited.
Methods
Cases of ASC‐US/hrHPV+ that were tested using HC2, Cervista, or Aptima were retrieved, and the immediate histologic correlations were analyzed.
Results
Overall, 53.9% (n = 3238) of women with ASC‐US/hrHPV+ had immediate histologic correlation. The detection rates for grade 1 cervical intraepithelial neoplasia (CIN1) were similar among the 3 methods (37.1%‐41.8%), while the overall detection rates for grade 2 CIN or higher (CIN2+) were much lower (5.1%‐9.0%). CIN2+ detection rates were similar among different age groups for HC2 testing, whereas for Cervista and Aptima testing, detection rates were highest in the youngest group (age <25 years) and decreased with age. Statistical analyses revealed that the CIN2+ detection rate was significantly higher in younger women who were tested with Cervista.
Conclusion
These hrHPV testing methods revealed low CIN2+ detection rates in women with ASC‐US/hrHPV+ but demonstrated different patterns when using age‐stratified analyses. The high rate of CIN2+ detection in women aged <25 years by the Cervista and Aptima testing platforms, but not the HC2 platform, suggest that continual investigation of FDA‐approved clinical hrHPV testing—especially large‐scale, long‐term, prospective studies—is needed to evaluate the best options for management of ASC‐US/hrHPV+ in this age group.