S38 Abstracts

screening tool, we compared the risk levels of high-grade cervical intra-

Graph of Table 2.
66
Molecular Testing and Cervical Screening: Will One Test Fit All?
Erin McCarthy, BS, CT(ASCP)1, Changhong Ye, BS, SCT(ASCP)2,
Daniel Kurtycz, MD2. 1University of Wisconsin, Madison, Wisconsin;
2
Wisconsin State Laboratory of Hygiene, Madison, Wisconsin
epithelial neoplasia (CIN2+) during a 3-year follow-up period in women aged
30 years and older who screened with HPV and Pap co-testing.
Materials and Methods: Patient records from the Cancer Prevention Center
were searched retrospectively for women aged 30 years and older who
underwent cervical cancer screening during 2007 and 2008. Screening
consisted of SurePath Pap and Hybrid Capture 2 (HC2) HPV co-testing.
Cumulative incidences of CIN2+ were compared to evaluate the risks
stratified by HPV and/or Pap testing results.
Results: During the study period, 5,739 women underwent screening. HPV
was positive in 3.75% (215/5,739) of the women. Of the 2,107 women for
whom 3-year follow-up data were available, 189 (9.0%) had a positive HPV
result and 188 (8.9%) had a positive Pap result (ASC-US+). During the 3-
year follow-up period, 20 women had a CIN2+ biopsy result (10 CIN2
cases, 10 CIN3 cases). The cumulative risk of CIN2+ in women with
a positive HPV result (8.5%) was significantly higher than that in women
with a negative HPV result (0.26%; P
Conclusions: During a 3-year screening interval, the risk of CIN2+ in
women aged 30 years and older with a HPV-negative result is sufficiently
low to ensure a safety margin for cervical cancer prevention, supporting the
use of HPV testing as a first-line screening tool for cervical cancer
prevention in women aged 30 and older.

Introduction: Over time, cervical screening has evolved from a simple

glass-slide smear to a sophisticated test involving liquid-based processing,
automated screening, and molecular human papillomavirus (HPV) testing.
Recent emphasis on molecular testing seeks to identify HPV strains
considered “high-risk” for carcinogenesis, with HPV 16 & 18 being the
main focus of research and clinical practice. But is molecular testing more
effective and efficient than morphologic testing for cervical screening?
Does current data on HPV hold true across all populations? As a public
health laboratory serving high-risk, underserved populations, these remain
important considerations for our practice.
Materials and Methods: Correlation of Pap and HPV results was performed
via retrospective review, focusing on Pap cases with high-grade diagnoses
and an associated HPV test using the cobasÒ 4800 HPV platform from Figure 1 Cumulative risk of CIN2+ by HPV or Pap cytology testing
Roche Diagnostics. HPV results included HPV 16, HPV 18, HPV Other
High-Risk, a combination of two or more groups, or HPV Not Detected.
The subject population consisted mostly of young women within 200%
or less of the poverty line.
Results: Of 2,818 cytology test cases reviewed from July 2013-March
2014, 74 were diagnosed as high-grade. HPV was not detected in 10
(13.51%) of these cases. Of the 64 positive HPV tests, 25 (39.06%) fell in
the Other High-Risk category. In total, 35 (52.57%) of the high-grade Pap
cases were not HPV 16/18 positive.
Conclusions: With recent changes to cervical screening practices and
guidelines, namely the emphasis on molecular HPV testing, the results of
this review are concerning. How will these changes in screening affect our
bottom line, both financially and prognostically? Is our patient population
substantially different from those used to develop popular testing algo-
rithms? As we move forward with evolution of cervical screening practices,
it will be important to explore these questions for the continued quality and
integrity of women’s health services. Figure 2 Cumulative risk of CIN2+ by HPV and Pap cytology testing

67
Can HPV Testing Be Used as a First-line Screening Test for Cervical 68
Cancer Prevention? Three-year Cumulative Risk of CIN2+ In Women Maximizing the Adequacy of CervistaÒ HPV Results on ThinPrepÒ Pap
Aged 30 Years and Older Screened by Pap and HPV Co-testing Samples Treated with Glacial Acetic Acid

Abha Khanna, MA, CT(ASCP), Marilyn Dawlett, CT(ASCP),
Teresa Kologinczak, BS, SCT(ASCP), IAC,
Jianping Wang, PhD, CT(ASCP), Shobhana Patel, BS, CT(ASCP),
Therese Bevers, MD, Nour Sneige, MD, Ming Guo, MD. University of
Texas MD Anderson Cancer Center, Houston, Texas
Introduction: Recently, HPV testing was approved as a first-line screening
tool for cervical cancer prevention by the U.S. Food and Drug Administration.
To evaluate whether HPV testing can be used effectively as a first-line
Aparna Mahajan, MD1, Erek Kucher, BS, CT (ASCP)2,
Shawna Engelhardt, CT(ASCP)2, William Rehrauer, PhD3,
Wanda Hoefle, MT(ASCP)3, Suzanne Selvaggi, MD3. 1University of
Wisconsin Hospital, Madison, Wisconsin; 2University of Wisconsin
Hospital and Clinics, Madison, Wisconsin; 3University of Wisconsin School
of Medicine and Public Health, Madison, Wisconsin
Introduction: Bloody ThinPrepÒ Pap test samples (TPTS) frequently have
high unsatisfactory rates. Since 2002, bloody TPTS have been

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