Accuracy of genotyping for HPV16 and 18 to triage women with low-grade squamous intraepithelial lesions: a pooled analysis of VALGENT studies

Marc Arbyn, Mario Poljak, Jesper Hansen Bonde , Kate Cuschieri

Research output: Contribution to journalArticlepeer-review

Abstract

Background:
Genotyping for the most carcinogenic HPV types (HPV16/HPV18) can identify high risk of underlying cervical precancer and guide further management.
Research design and methods:
A pooled analysis was performed of the clinical accuracy of high-risk HPV testing and HPV16/18 genotyping in triage of women with low grade squamous intraepithelial lesions (LSIL). Data regarding 24 assays evaluated in four VALGENT validation panels were used.
Results:
In women with LSIL, hrHPV had a pooled sensitivity for CIN2+ of 95.5% (95% CI: 91.0-97.8%) and a specificity of 25.3% (95% CI: 22.2-28.6%). HPV16/18 genotyping had a sensitivity and specificity for CIN2+ of 52.9% (95% CI: 48.4-57.4%) and 83.5% (95% CI: 79.9-86.5%), respectively. The average risk of CIN2+ was 46.1% when HPV16/18-positive, 15.5% in women who were HPV16/18-negative but positive for other hrHPV types and 4.3% for hrHPV-negative women.
Conclusions:
Triage of women with LSIL with HPV16/18 genotyping increases the positive predictive value compared to hrHPV testing but at the expense of lower sensitivity. Arguably, women testing positive for HPV16/18 need further clinical work-up. Whether colposcopy referral or further surveillance is recommended for women with other hrHPV types may depend on the post-test risk of precancer and the local risk-based decision thresholds.
Original languageEnglish
Pages (from-to)543-551
JournalExpert Review of Molecular Diagnostics
Volume19
Issue number6
Early online date29 Apr 2019
DOIs
Publication statusPublished - 8 May 2019

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