CYTOLOGICAL EVALUATION AND MOLECULAR HUMAN PAPILLOMAVIRUS TEST OF CERVICAL SCRAPINGS FROM WOMEN TREATED FOR CONDYLOMA

The incidence of cervical carcinoma has decreased by about half since cytological screening was introduced in Sweden in the 1960s. This is a n encouraging but not altogether satisfactory development. Human papil lomaviruses (HPVs) are known to be potential agents in the etiology of cervical cancer. Therefore, an additional HPV test might well improve the detection rate of high-grade cervical intraepithelial neoplasia ( GIN). The purpose of this investigation was to compare the correlation of cytology and HPV testing in a pilot study of 94 women recruited fr om a clinic for sexually transmitted diseases after condyloma treatmen t and to check earlier established molecular biological assays. Cervic al scrapings, taken for simultaneous Pap smear and molecular HPV DNA t esting, were assessed by the polymerase chain reaction. Of the 94 wome n tested, 47 (50%) had normal cytology and negative HPV DNA; 36 (38%) had normal cytology but positive HPV DNA, 26 (72%) of whom harbored hi gh-risk HPVs; 1 (1%) had abnormal cytology but negative HPV DNA, and 1 0 (11%) had abnormal cytology and positive HPV DNA, 5 (50%) of whom ha rbored high-risk HPVs. It is concluded that an HPV test would add grea ter specificity and possibly also greater sensitivity to cytology for detecting or predicting high-grade GIN. This information may be of val ue when designing future gynecological screening programs.