This observational study aimed to establish the prevalence of hrHPV in women attending three inner London community clinics for routine screening and to pilot hrHPV testing in the triage of either borderline or negative cytology after previous abnormalities. hrHPV positivity prompted earlier referral of women with previous abnormalities and either low-grade or negative cytology.
The hrHPV was detected in 111/161 women with abnormal cytology, 76/460 with negative cytology after previous abnormalities, and 105/813 with negative cytology and no exceptions mentioned above. Overall, hrHPV was detected in 292/1434 women in the study. hrHPV prevalence increased with cytological abnormality severity and decreased with age, both with negative and low-grade cytology. High-grade CIN biopsies were found more frequently in women in the study groups with low-grade or negative cytology than in routine colposcopies. Still, more women in the study groups attended colposcopy.
The study concluded that hrHPV positivity increased detection of high-grade CIN in the study groups at the expense of more colposcopies. hrHPV negativity could reduce the need to investigate low-grade cytology in women aged over 35 years and for surveillance after previous abnormalities.