Influence of high risk HPV genotype on colposcopic performance: A large prospective study demonstrates improved detection of disease with ZedScan I , particularly in non-HPV 16 patients

Abstract

The use of an electrical impedance spectroscopic device (ZedScan I) increases detection of CIN2+ irrespective of hrHPV genotype.

Prevalence of high‐grade cervical intraepithelial neoplasia in women with persistent high‐risk HPV genotypes and negative cytology

“…16 We have previously reported in a series of 839 women referred to colposcopy a significant reduction in performance of colposcopy in detection of high grade CIN in women with HPVO genotypes when compared with HPV16 (79.7% vs 86.9%) including women referred with persistent HPV negative cytology. 4 The biopsy rate of 31% in this study is higher than reported elsewhere in the literature. Ronco's review of four European studies, investigating the efficacy of HPV testing, showed biopsy rates ranging from 2% to 11%.…”

“…In populations with higher levels of high‐grade CIN, HPV genotyping may have less impact on colposcopic impression and identification of disease . We have previously reported in a series of 839 women referred to colposcopy a significant reduction in performance of colposcopy in detection of high grade CIN in women with HPVO genotypes when compared with HPV16 (79.7% vs 86.9%) including women referred with persistent HPV negative cytology . In addition, HPVO may cause more low‐grade disease as suggested by Howell‐Jones and colleagues who reported HPVO was most frequently associated with low‐grade cytological screening abnormalities …”

“…From April 2014 we began to see women referred with persistently positive HPV16/18 and cytology negative samples and the following year (April 2015) we began to see women referred with persistently positive hrHPV Other (HPVO) and cytology negative samples (Figure ). ZedScan has been in routine use in our colposcopy clinic since 2013 and has been shown to increase the detection of HG‐CIN irrespective of hrHPV genotype …”

“…ZedScan has been in routine use in our colposcopy clinic since 2013 and has been shown to increase the detection of HG-CIN irrespective of hrHPV genotype. 4 The impact of HPV primary screening upon women referred to colposcopy, and on colposcopy services as yet remains unreported in the UK despite the announcement of national implementation by 2019 at the latest. This paper aims to assess the impact of HPV primary screening on colposcopy, paying particular attention to HPV referral genotype, colposcopic opinion, biopsy rates, treatment and follow-up rates; as well as the impact of HPV primary screening on our referred population regarding overall detection of disease, detection of disease by HPV genotype, final diagnoses and patient outcomes.…”

Use of electrical impedance spectroscopy as an adjunct to colposcopy in a pathway of cervical intraepithelial neoplasia diagnostics

“…They reported 18 cases with colposcopic impression and EIS indicating high-grade disease along with an agreement with histological diagnosis of high-grade CIN which suggest a 100% sensitivity and specificity; however, the reported sample was small. Macdonald et al [15] evaluated the impact of hrHPV infection on the accuracy of a diagnostic procedure carried out with colposcopies and EIS as an adjunct. Their study included the largest cohort of 839 women.…”