Immediate risk of HSIL presence in women who have both ASC-US cytology and negative high-risk HPV test

Purpose: The authors aimed to detect immediate risk of having high grade squamous lesions (HSIL) in atypical squamous cells of uncertain significance(AS-CUS) and concomitant high-risk human papillomavirus (HrHPV) testing as negative [HrHPV(negative)ASCUS]. Materials and Methods: The authors performed immediate/baseline colposcopy on concomitant HrHPV (negative)AS-CUS cases. Pap tests were evaluated with liquid-based cytology (LBC) and HrHPV detection was performed in LBC material with PCR. Colposcopic diagnoses and biopsy results were compared with Pap test and HrHPV test results. Results: There were 104 patients over a oneyear period. In all, 84 cases were included. Colposcopic biopsies revealed low grade squamous intraepithelial lesion (LSIL) in 19 cases (23%) and HSIL in three cases (4%). Intrauterine device use and smoking were significantly correlated with presence of HSIL (p = 0.005 and p = 0.007 respectively). Conclusion: Similar data in literature, 4% of ASC-US-HrHPV (negative) cases are expected to have HSIL in follow-up periods less than six months. The present authors believe clinicians should be more open with their patients about limitations of Pap-HPV testing.

ASC-US; Cervical cancer screening; Human papillomavirus; Human papillomavirus DNA tests.

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