Authors' objectives:

The aim of this report is to evaluate the use of human papillomavirus (HPV) DNA testing for the screening and monitoring of cervical cancer.

Authors' recommendations: With regard to human papillomavirus (HPV) DNA testing for the screening and monitoring of cervical cancer, the ICSI Technology Assessment Committee finds the following: 1. In women 30 years of age or older who have an ASCUS (atypical squamous cells of undetermined significance) cervical cytology result, the HPV DNA test, when performed as a reflex test (where performance of the test is contingent on an ASCUS cytology) is safe and efficacious for use in selecting women for referral to colposcopy and biopsy (positive HPV DNA test) or for monitoring at 6 months and 12 months (negative HPV DNA test). (Conclusion Grade II) 2. In women 30 years of age or older, automatic HPV DNA testing is safe and efficacious for use as an adjunct to cervical cytology to allow less frequent screening for cervical cancer. If both the HPV DNA and the cervical cytology results are negative, the woman is considered at low risk for cervical cancer. Such women may be screened at longer intervals, such as every three years. This conclusion is not applicable for women with a recent change in sexual partner. (Conclusion Grade II) 3. The evidence does not support the use of HPV DNA testing alone as a primary screening tool. Therefore, HPV DNA testing should not be used as a standalone test in this capacity. 4. There is not enough evidence to permit conclusions regarding the use of HPV DNA testing for the monitoring of treatment response or in selecting patients at high risk of relapse following treatment of CIN or cervical cancer. 5. The test procedure for HPV DNA is safe. The risk lies in what is done with the results. Failure to diagnose high-grade squamous intraepithelial lesions (HSIL) or invasive cervical cancer (false negative) or referral to colposcopy or biopsy when not needed (false positive) may result in morbidity or mortality.

Authors' methods: Review

Project Status: Completed

URL for project: http://www.icsi.org/knowledge/detail.asp?catID=107&itemID=286

Year Published: 2005

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: United States

Organisation Name: Institute for Clinical Systems Improvement

Contact Address: 8009 34th Avenue South, Suite 1200, Bloomington, MN, USA. Tel: +1 952 814 7060; Fax: +1 952 858 9675

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Contact Email: icsi.info@icsi.org

Copyright: Institute for Clinical Systems Improvement (ICSI)