Triage with human papillomavirus testing of women with cytologic abnormalities prompting referral for colposcopy assessment

BACKGROUND. The current study was conducted to evaluate the cost- effectiveness of triaging for colposcopy using human papillornavirus (HPV) testing. METHODS. HPV tests were performed in a consecutive series of women who were referred for colposcopy for persistent atypical squarnous cells of undetermined significance (ASCUS)-favor reactive (n = 35 women), ASCUS-favor squamous epithelial lesion (n - 164 women), atypical glandular cells of undetermined significance (n - 74 women), low-grade squamous epithelial lesion (n - 161 women), or high-grade squamous epithelial lesion (n = 78 women). The cost effectiveness of triaging women with ASCUS results using HPV testing was determined compared with the Current protocol. RESULTS. The sensitivity of HPV testing for cervical intraepithelial neoplasia greater than or equal to Grade 2 was very high. Cost analysis showed a moderate increase in cost with the addition of HPV triage. CONCLUSIONS. Because HPV testing is highly sensitive, it may be useful as an alternative to the current policy of 6-month repeat cytology for women with ASCUS. (C) 2004 American Cancer Society.