Hybrid capture based human papillomavirus typing in cervical screening compared to cytology and histology

Introduction: Cervical cancer is frequently associated with infection from various types of human papillomavirus (HPV) with high a oncogenic potential (high-risk types). Commercial systems for HPV typing are available, but th e question as to when HPV typing should be performed has not yet been solve d. Objectives. To assess the value of HPV typing in a clinical setting in a po pulation with opportunistic screening. Study design: Cytology, histology and HPV status of 593 patients from a hig h-risk collective were evaluated retrospectively. For HPV typing, the hybri d capture (HC) system was used. Results. Infection with high-risk types of HPV was associated with more sev ere cervical lesions. Women with PAP III or PAP IIID who were infected with high-risk HPV were at increased risk for high-grade cervical lesions (CIN III+) (p=0.006). Conization influenced HPV status: of 63 patients who were HPV high-risk positive before conization, 4 remained positive afterwards. Conclusion: HC appears to be a useful system to triage women with PAP III o r IIID and to detect patients with residual HPV infection after conization. However, because of high costs and no significant increase in the sensitiv ity of cytology, the use of HPV typing in routine cervical screening cannot be recommended in countries with opportunistic annual cytological screenin g.