Human papillomavirus (HPV) DNA assay as an adjunct to liquid-based Pap test in the diagnostic triage of women with an abnormal Pap smear

Objective: The diagnostic performance and clinical value of the combined use of liquid-based Pap test and human papillomavirus testing were determined in 336 patients with a previous abnormal smear. Method: Subsequent histologic evaluation was used as definitive diagnosis. Result: The combined use of liquid-based Pap test and HPV DNA testing showed higher rates in sensitivity (99.0%), specificity (59.3%), positive predictive value (89.9%) and negative predictive value (94.5%) than either cytology alone (sensitivity 98.8%, specificity 45.7%, positive predictive value 84.7%, negative predictive value 92.6%) or HPV DNA testing alone (sensitivity 84.9%, specificity 67.4%, positive predictive value 88.8%, negative predictive value 59.5%). Conclusion: The study demonstrated that the diagnostic accuracy for cervical cancer and its precursors was improved by using the liquid-based Pap test as a primary diagnostic procedure and HPV assay as an adjunctive test. This information may assist the clinicians in triaging patients with equivocal cytologic cervical atypias. (C) 1998 International Federation of Gynecology and Obstetrics.