Influence of Prior Knowledge of Human Papillomavirus Status on the Performance of Cytology Screening

Author(s)

Martins, Toni Ricardo ^{[1, 2]} ; Longatto-Filho, Adhemar ^{[3, 4, 5, 6, 7]} ; Cohen, Diane ^[8] ; Kodaira Viscondi, Juliana Yukari ^[9] ; Fuza, Luiz Mario ^{[1, 8]} ; Cury, Lise ^[8] ; Villa, Luisa Lina ^{[10, 6, 11]} ; Levi, Jose Eduardo ^{[1, 6]} ; Eluf-Neto, Jose ^{[9, 8, 6]}

Affiliation:Show less -

^[1] Univ Sao Paulo, Inst Trop Med, Virol Lab, Sao Paulo - Brazil

^[2] Univ Sao Paulo, Dept Infect Dis, Sch Med, Sao Paulo - Brazil

^[3] ICVS 3Bs PT Govt Associate Lab, Braga - Portugal

^[4] Univ Sao Paulo, Fac Med, Lab Med Invest LIM 14, Sao Paulo - Brazil

^[5] Pio XII Fdn, Barretos Canc Hosp, Mol Oncol Res Ctr, Barretos - Brazil

^[6] Inst Nacl Ciencia & Tecnol Doencas Papilomavirus, Sao Paulo - Brazil

^[7] Univ Minho, Sch Hlth Sci, Liffe & Hlth Sci Res Inst ICVS, Braga - Portugal

^[8] Fundacao Oncoctr Sao Paulo, Oscar Freire St 2396, BR-05409012 Sao Paulo, SP - Brazil

^[9] Univ Sao Paulo, Fac Med, Dept Prevent Med, Sao Paulo - Brazil

^[10] Univ Sao Paulo, Fac Med, Dept Radiol & Oncol, Sao Paulo - Brazil

^[11] Inst Canc Estado Sao Paulo, Ctr Invest Translac Oncol, Sao Paulo - Brazil

• Document type: Journal article
• Source: AMERICAN JOURNAL OF CLINICAL PATHOLOGY; v. 149, n. 4, p. 316-323, APR 2018.
• Web of Science Citations: 1

Abstract

Objectives: This study aimed to evaluate the influence of prior knowledge of human papillomavirus (HPV) status in cervical cytopathology readings. Methods: Participants comprised 2,376 women who underwent parallel cytology and HPV-DNA testing. Smears were read twice by the same team, first with previous knowledge of HPV-DNA status. Results: Overall, 239 (10.2%) smears had their cytology classification altered by the HPV-informed review. Cytology readings with prior knowledge of the HPV status revealed 10.5% of abnormal smears (atypical squamous cells of undetermined significance or higher), while without prior knowledge, this rate dropped to 7.6%. When HPV status was informed, a significant increase in all categories of altered smears was observed. Cytology with prior knowledge of HPV status detected more cervical intraepithelial neoplasia grade 2 or higher (CIN 2+) compared with blinded: 86.7% vs 60.0%. Conclusions: Our data indicate that cytology interpreted with prior knowledge of the HPV status provides higher sensitivity for CIN 2+ lesions while marginally reducing the overall specificity compared with HPV status blinded cytology. (AU)

• FAPESP's process: 08/57889-1 - Institute of Science and Technology to study Diseases Associated with Papillomavirus
• Grantee: Luisa Lina Villa
• Support Opportunities: Research Projects - Thematic Grants