Cervical cancer screening by molecular Pap‐transformation of gynecologic cytology

Background

Cervical cancer is one of the common cancers in women accounting for 7.9% of all cancers. In India it is the second commonest cancer in women. The immortality of the cancer cell and the relatively long time frame from acquisition of infection to development of cervical cancer was established. As major advancements like LBC, HPV testing were introduced in the recent years, screening has taken a new avatar, the Molecular pap!! The objectives of this study were: To compare gynecologic cytology and abnormal results with respect to conventional and LBC. To study the role of HPV cotesting and ancillary tests performed, that is, HPV CISH, and p16ink4a by IHC.

Methods

About 71 924 Conventional and LBC samples were included from August 2009 to December 2017. Cases for HPV testing along the conventional smears were 1539. HPV can be tested from the same LBC vial as the sample remains stable at room temperature for 6 weeks. HPV DNA PCR was carried out in our laboratory for High and Low risk genotypes. Cytology findings were also correlated with histology.

Results

Detection rate of SILs in LBC samples were higher (2.20%). The commonest abnormality was LSIL in LBC and ASCUS in conventional smears. Commonest HR HPV and LR HPV detected was 1 61 856 and 61 142.

Conclusion

LBC with HPV cotesting improves sensitivity and specificity and reduces ambiguous results; allows better compliance, as a negative result of both tests allows patients to get screening every 5 years, thereby increasing screening intervals, important in a resource limited situation.

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