The hr-HPV based cervical cancer screening: results of a four-years experience in a single screening center of Italy

Purpose of Investigation: The study was performed to evaluate four years of experience (2012-2015) in high risk-human papillomavirus (hr-HPV) testing in the cervical cancer screening in Latina (Italy). Materials and Methods: The hr-HPV as primary test is performed only on women aged 35-64, followed by a Pap test as triage, while women aged 25-34 are invited to perform only a Pap test. Results: Women resulted positive to hr-HPV test and positive to Pap test were 5.6% and 4.1%, respectively. Among women aged 25-34, the hr-HPV test was used as triage for women with atypical squamous cells of undetermined significance (ASCUS) and 69.9% resulted positive to the test. The positive predictive value (PPV) for high cervical intraepithelial lesions (HSIL) was higher in women aged 35-64 (9.9% vs. 6.9%), while the detection rate (DR) for HSIL was higher in young women (2.4‰ vs. 1.2‰). The authors found that 52.5% of women with hr-HPV+/Pap test resulted with hr-HPV+ at one-year recall and the DR for HSIL lesions of this population was very low (0.27‰). Discussion: The present data confirms that the application of hr-HPV test showed elevated performance in cervical cancer screening and that the application of hr-HPV test in managing ASCUS leads to a decreased use of inappropriate colposcopies. Finally, it may be useful to extend the period of follow-up for women hr-HPV+/Pap test to reduce unnecessary colposcopies.