March 2004 · Vol. 16, No. 3Atypical squamous cells:
The case for HPV testing
New data, terminology, and guidelines are in, and human papillomavirus testing is emerging as the most efficient and cost-effective triage option.
J.
THOMAS
COX,
MDDr. Cox is director of the gynecology clinic, student health services, University of California at Santa Barbara.
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KEY POINTS
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Management by immediate colposcopy, repeat cytology, or HPV testing is acceptable for ASC-US, but testing for HPV is preferred when the Pap test is liquid-based.
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The sensitivity of HPV triage for high-grade CIN is essentially equivalent to colposcopy, and reduces the need for colposcopy by half.
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HPV testing is a good option for follow-up after treatment with cryosurgery, loop electrosurgical excision procedure, laser, or cold-knife conization.
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What’s the best management strategy for the roughly 2 to 3 million women each year1,2 with atypical squamous cells on Pap test?
This question is vital because about 1 in 1,000 women with atypical squamous cells of undetermined significance (ASCUS) already has invasive cervical cancer. While the risk is small for each woman, ASCUS accounts for about 2,500 cervical cancers and 222,000 cases of cervical intraepithelial neoplasia (CIN) 3 every year.3
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