ASC-US and HPV testing in women aged 40 years and over

High-risk human papillomavirus (HPV) DNA triage is commonly performed for cervical cytology specimens interpreted as atypical squamous cells of undetermined significance (ASC-US), but little is known about testing results in women greater than or equal to40 yr of age. The extent to which clinical,follow-up after HPV testing reflects the most recent management guidelines is unknown also. Data from 108 patients greater than or equal to40 yr of age with concurrent (93 patients) or recent (15 patients) ASC-US interpretations and HPV testing were reviewed. Twenty-five (23.1%) of these patients were positive for high-risk HPV The HPV+ rate was higher in women with a current interpretation of ASC-US (26.9%) compared with those with a previous ASC-US result (0%). Many patients were not managed exactly according to the "2001 Consensus Guidelines for the Management of Women with Cervical Cytologic Abnormalities." The majority (52.6%) of women with HPV+ ASC-US did not receive colposcopy in our institution, and 41.3% of women with HPV- ASC-US received follow-up testing within 8 mo. These results show the potential for inadequate evaluation of women with HPV+ ASC-US, as well as unnecessary early repeat cytology in HPV- ASC-US patients. Therefore, additional clinician education and reminders to correlate cytology and HPV test results may be warranted to optimize patient care. (C) 2004 Wiley-Liss, Inc.