HPV testing as an adjunct to cytology in the follow-up of women treated for cervical intraepithelial neoplasia

Henry Kitchener (Corresponding Author), Patrick Walker, Linsey Nelson, Richard Hadwin, Julietta Patnick, Catherine Moore, Margaret Eleanor Cruickshank

    Research output: Contribution to journalArticle

    68 Citations (Scopus)

    Abstract

    OBJECTIVE: To evaluate human papillomavirus (HPV) testing in combination with cytology in the follow up of treated women.

    DESIGN: A prospective study.

    SETTING: Three UK centres: Manchester, Aberdeen and London.

    POPULATION OR SAMPLE: Women treated for cervical intraepithelial neoplasia (CIN).

    METHODS: Women were recruited at 6 months of follow up, and cytology and HPV testing was carried out at 6 and 12 months. If either or both results were positive, colposcopy and if appropriate, a biopsy and retreatment was performed. At 24 months, cytology alone was performed.

    MAIN OUTCOME MEASURES: Cytology and histology at 6, 12 and 24 months.

    RESULTS: Nine hundred and seventeen women were recruited at 6 months of follow up, with 778 (85%) and 707 (77.1%) being recruited at 12 and 24 months, respectively. At recruitment, 700 women had had high-grade CIN (grades 2 or 3) and 217 had CIN1. At 6 months, 14.6% were HPV positive and 10.7% had non-negative cytology. Of those with negative cytology, 9% were HPV positive. Of the 744 women who were cytology negative/HPV negative at baseline, 3 women with CIN2, 1 with CIN3, 1 with cancer and 1 with vaginal intraepithelial neoplasia (VAIN)1 were identified at 24 months. Nine of 10 cases of CIN3/cervical glandular intraepithelial neoplasia (CGIN) occurred in HPV-positive women. At 23 months, cancer was identified in a woman treated for CGIN with clear resection margins, who had been cytology negative/HPV negative at both 6 and 12 months.

    CONCLUSIONS: Women who are cytology negative and HPV negative at 6 months after treatment for CIN can safely be returned to 3-year recall.

    Original languageEnglish
    Pages (from-to)1001-1007
    Number of pages7
    JournalBritish Journal of Obstetrics and Gynaecology
    Volume115
    Issue number8
    Early online date22 May 2008
    DOIs
    Publication statusPublished - Jul 2008

    Fingerprint

    Cervical Intraepithelial Neoplasia
    Cell Biology
    Neoplasms
    Colposcopy
    Retreatment
    Histology
    Prospective Studies
    Biopsy

    Keywords

    • HPV CIN colposcopy LLETZ
    • cytology
    • follow up
    • HPV testing

    Cite this

    HPV testing as an adjunct to cytology in the follow-up of women treated for cervical intraepithelial neoplasia. / Kitchener, Henry (Corresponding Author); Walker, Patrick; Nelson, Linsey; Hadwin, Richard ; Patnick, Julietta; Moore, Catherine; Cruickshank, Margaret Eleanor.

    In: British Journal of Obstetrics and Gynaecology, Vol. 115, No. 8, 07.2008, p. 1001-1007.

    Research output: Contribution to journalArticle

    Kitchener, Henry ; Walker, Patrick ; Nelson, Linsey ; Hadwin, Richard ; Patnick, Julietta ; Moore, Catherine ; Cruickshank, Margaret Eleanor. / HPV testing as an adjunct to cytology in the follow-up of women treated for cervical intraepithelial neoplasia. In: British Journal of Obstetrics and Gynaecology. 2008 ; Vol. 115, No. 8. pp. 1001-1007.
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    abstract = "OBJECTIVE: To evaluate human papillomavirus (HPV) testing in combination with cytology in the follow up of treated women. DESIGN: A prospective study. SETTING: Three UK centres: Manchester, Aberdeen and London. POPULATION OR SAMPLE: Women treated for cervical intraepithelial neoplasia (CIN). METHODS: Women were recruited at 6 months of follow up, and cytology and HPV testing was carried out at 6 and 12 months. If either or both results were positive, colposcopy and if appropriate, a biopsy and retreatment was performed. At 24 months, cytology alone was performed. MAIN OUTCOME MEASURES: Cytology and histology at 6, 12 and 24 months. RESULTS: Nine hundred and seventeen women were recruited at 6 months of follow up, with 778 (85{\%}) and 707 (77.1{\%}) being recruited at 12 and 24 months, respectively. At recruitment, 700 women had had high-grade CIN (grades 2 or 3) and 217 had CIN1. At 6 months, 14.6{\%} were HPV positive and 10.7{\%} had non-negative cytology. Of those with negative cytology, 9{\%} were HPV positive. Of the 744 women who were cytology negative/HPV negative at baseline, 3 women with CIN2, 1 with CIN3, 1 with cancer and 1 with vaginal intraepithelial neoplasia (VAIN)1 were identified at 24 months. Nine of 10 cases of CIN3/cervical glandular intraepithelial neoplasia (CGIN) occurred in HPV-positive women. At 23 months, cancer was identified in a woman treated for CGIN with clear resection margins, who had been cytology negative/HPV negative at both 6 and 12 months. CONCLUSIONS: Women who are cytology negative and HPV negative at 6 months after treatment for CIN can safely be returned to 3-year recall.",
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    TY - JOUR

    T1 - HPV testing as an adjunct to cytology in the follow-up of women treated for cervical intraepithelial neoplasia

    AU - Kitchener, Henry

    AU - Walker, Patrick

    AU - Nelson, Linsey

    AU - Hadwin, Richard

    AU - Patnick, Julietta

    AU - Moore, Catherine

    AU - Cruickshank, Margaret Eleanor

    PY - 2008/7

    Y1 - 2008/7

    N2 - OBJECTIVE: To evaluate human papillomavirus (HPV) testing in combination with cytology in the follow up of treated women. DESIGN: A prospective study. SETTING: Three UK centres: Manchester, Aberdeen and London. POPULATION OR SAMPLE: Women treated for cervical intraepithelial neoplasia (CIN). METHODS: Women were recruited at 6 months of follow up, and cytology and HPV testing was carried out at 6 and 12 months. If either or both results were positive, colposcopy and if appropriate, a biopsy and retreatment was performed. At 24 months, cytology alone was performed. MAIN OUTCOME MEASURES: Cytology and histology at 6, 12 and 24 months. RESULTS: Nine hundred and seventeen women were recruited at 6 months of follow up, with 778 (85%) and 707 (77.1%) being recruited at 12 and 24 months, respectively. At recruitment, 700 women had had high-grade CIN (grades 2 or 3) and 217 had CIN1. At 6 months, 14.6% were HPV positive and 10.7% had non-negative cytology. Of those with negative cytology, 9% were HPV positive. Of the 744 women who were cytology negative/HPV negative at baseline, 3 women with CIN2, 1 with CIN3, 1 with cancer and 1 with vaginal intraepithelial neoplasia (VAIN)1 were identified at 24 months. Nine of 10 cases of CIN3/cervical glandular intraepithelial neoplasia (CGIN) occurred in HPV-positive women. At 23 months, cancer was identified in a woman treated for CGIN with clear resection margins, who had been cytology negative/HPV negative at both 6 and 12 months. CONCLUSIONS: Women who are cytology negative and HPV negative at 6 months after treatment for CIN can safely be returned to 3-year recall.

    AB - OBJECTIVE: To evaluate human papillomavirus (HPV) testing in combination with cytology in the follow up of treated women. DESIGN: A prospective study. SETTING: Three UK centres: Manchester, Aberdeen and London. POPULATION OR SAMPLE: Women treated for cervical intraepithelial neoplasia (CIN). METHODS: Women were recruited at 6 months of follow up, and cytology and HPV testing was carried out at 6 and 12 months. If either or both results were positive, colposcopy and if appropriate, a biopsy and retreatment was performed. At 24 months, cytology alone was performed. MAIN OUTCOME MEASURES: Cytology and histology at 6, 12 and 24 months. RESULTS: Nine hundred and seventeen women were recruited at 6 months of follow up, with 778 (85%) and 707 (77.1%) being recruited at 12 and 24 months, respectively. At recruitment, 700 women had had high-grade CIN (grades 2 or 3) and 217 had CIN1. At 6 months, 14.6% were HPV positive and 10.7% had non-negative cytology. Of those with negative cytology, 9% were HPV positive. Of the 744 women who were cytology negative/HPV negative at baseline, 3 women with CIN2, 1 with CIN3, 1 with cancer and 1 with vaginal intraepithelial neoplasia (VAIN)1 were identified at 24 months. Nine of 10 cases of CIN3/cervical glandular intraepithelial neoplasia (CGIN) occurred in HPV-positive women. At 23 months, cancer was identified in a woman treated for CGIN with clear resection margins, who had been cytology negative/HPV negative at both 6 and 12 months. CONCLUSIONS: Women who are cytology negative and HPV negative at 6 months after treatment for CIN can safely be returned to 3-year recall.

    KW - HPV CIN colposcopy LLETZ

    KW - cytology

    KW - follow up

    KW - HPV testing

    U2 - 10.1111/j.1471-0528.2008.01748.x

    DO - 10.1111/j.1471-0528.2008.01748.x

    M3 - Article

    VL - 115

    SP - 1001

    EP - 1007

    JO - British Journal of Obstetrics and Gynaecology

    JF - British Journal of Obstetrics and Gynaecology

    SN - 0306-5456

    IS - 8

    ER -