Human papillomavirus testing as an adjunct to cytology evaluation in cervical specimens of selected and consecutively screened Lebanese women: a prospective clinical study

ABSTRACT

Cervical cancer is the second leading cancer in women worldwide, with 85-100% of cervical cancers being HPV DNA positive. Our study aimed at evaluating the use of HPV DNA testing as an adjunct to the routine cervical cytology evaluation of Lebanese women. Cervical cytology evaluation and testing for human papillomavirus [HPV], as well as high-risk HPV were performed on two groups of women. One group consisted of 274 healthy women attending gynecology clinics for routine evaluation, while the other included 199 women selected based on a high-risk lifestyle and/or abnormal findings at cytology. HPV and HR-HPV DNA were 4 and 10 times higher, and HPV was 4 to 5 times more frequent at all age groups in selected, compared to healthy women. HPV infection decreased in healthy women with age but did not decrease in selected women. HPV positive-normal cytology decreased with age in both groups. Although HR-HPV detection decreased with age in healthy women, it doubled in selected women. In addition, more severe cytology was associated almost uniquely with selected women. HR-HPV detection and advanced cytology lesions correlated well and were mutually predictive. The overall sensitivity, specificity, positive and negative predictive values of HPV testing for squamous intraepithelial lesions were [85.5%], [90.95], [67.8%] and 96.5%, respectively. Based on these findings, we recommend implementing HPV screening as an adjunct to routine cervical cytology in selected Lebanese women older than 30 years of age