The knowledge on the etiological role of high-grade Human papillomavirus (hr-HPV) have caused a radical change in the cervical cancer prevention program by introducing hr-HPV test instead of PapTest as a primary test in the screening program The aim of this study was to evaluate the impact of the hr-HPV test in the cervical cancer screening in the Latina district (Italy) over a four-year period.
The population was divided in two groups: the hr-HPV as primary test was performed only on women aged 35-64, followed by a PapTest as triage, while women aged 25-34 were invited to perform only a PapTest.
5.6% of women presented with a positive hr-HPV test and 4.1% presented with a positive PapTest. In the group of women aged 25-34, the hr-HPV test was used as triage for women with ASCUS and 69.9% presented with a positive test. The PPV for high cervical intraepithelial lesions (CIN2+) was higher in women aged 35-64 (9.9% vs 6.9%), while the DR for CIN2+ lesions was higher in young women (2.4 ‰ vs 1.2 ‰). Moreover, we found that 52.5% of women hr-HPV+/PapTest- resulted hr-HPV+ at 1-year recall and the DR for CIN2+ lesions of this population was very low (0.27‰).
Our data confirms that the application of Italian guidelines showed high level of performance; moreover, our data confirms that the application of hr-HPV test in the management of ASCUS leads to a decreased of inappropriate colposcopy due to transitory infection in young women. Finally, because of the small number of CIN2+ lesions, it may be useful to extend the period of follow-up for women hr-HPV+/PapTest- to reduce the number of unnecessary colposcopies due to transitory infections.