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The devil is in the details.

Get the facts. Know her risk.

How would you treat these women?

Patient Case Study 1

Patient Case Study 1 Female 25 Years GO

A female 25-year-old GO presents with a history of ASC-US Pap and positive hrHPV result. 

The colposcopy fails to reveal any lesions.

What do the ASCCP guidelines say to do?

ASCCP guidelines:1

ASCCP suggests that women with ASC-US who are hrHPV+ be referred for colposcopy.1

HPV testing to triage ASC-US cytology in women ≥21 years

The ASCCP guidelines support the use of hrHPV DNA testing as an alternative to Pap cytology at 6 and 12 months or immediate colposcopy:

  • hrHPV negative women are recommended for repeat Pap cytology at 12 months
  • hrHPV positive women should be considered for colposcopy:
    • Those with CIN should be managed per ASCCP guidelines
    • Those with no CIN and hrHPV positive are recommended for Pap cytology at 6 and 12 months or hrHPV DNA testing at 12 months

If using Pap cytology only, women with ASC-US cytology on a repeat test are recommended for repeat colposcopy. 

Absolute risk of CIN2 according to genotype

  • The cobas® HPV Test helps you follow the guidelines by providing pooled hrHPV results. 

  • The cobas® HPV Test also provides individual HPV 16 and HPV 18 results to help you identify those women at highest risk who may need more intensive postcolposcopic follow-up


Absolute risk of ≥CIN2 stratified by hrHPV status in the ATHENA ASC-US population2

Discover a woman's risk for ≥CIN2 or  find a lab near you that offers the  cobas® HPV Test. 

Patient Case Study 2

Patient Case Study 1 Female 32 Year GO

A female 32-year-old G1P1 presents for routine screening. 

Her prior Pap was 5 years ago and was reported as negative. Her current pap is also negative, but she tested hrHPV+.

What do the guidelines say?

ACOG, ASCCP, ASCP, and ACS guidelines:

  • ACOG, ASCCP, ASCP, and ACS state that HPV DNA tests specific for HPV type 16 or HPV 16/18 can be used as an adjunct in women with negative Pap test results, but who have tested positive for hrHPV by an assay testing for 13 or 14 high-risk types, in women aged 30 years or older. 3, 4
  • Moreover, new professional guidelines from ACOG, ASCCP, ASCP, and ACS suggest that women with normal cytology who are HPV type 16 or HPV 16/18 positive be referred directly for colposcopy.3,  4
 

Co-testing in women aged 30-65

The American Cancer Society (ACS), the American Society for Colposcopy and Cervical Pathology (ASCCP), and the American Society for Clinical Pathology (ASCP) jointly issued guidelines for the prevention and early detection of cervical cancer in March 2012. The American Congress of Obstetricians and Gynecologists (ACOG) issued a new practice bulletin on screening for cervical cancer in November 2012.  The harmonized ACS, ASCCP, and ASCP guidelines, as well as the ACOG practice bulletin on screening for cervical cancer, state that co-testing using HPV testing in addition to a Pap test every 5 years is preferable to using a Pap test alone every 3 years for women ages 30–65 years.3,  4

Review detailed recommendations from the guidelines

Role of genotyping when screening3, 4

ACOG, ASCCP, ASCP, and ASC now recommend that in women 30-65 years of age, individual genotyping for HPV 16 or HPV 16 and 18 be considered when women have a normal cytology (Pap test) result but have positive results on a test for “pooled” high-risk HPV types. As an alternative for managing these patients, the guidelines continue to offer the option of repeating Pap and HPV testing at a one-year interval.

  • The guidelines suggest that women with normal cytology who are HPV 16+ or HPV 16/18+ be considered for immediate colposcopy.3,  4
  • If women with normal cytology are HPV positive, but HPV 16 or HPV 16/18 negative, 12 month follow up with co-testing is recommended. 3, 4 

Absolute risk of high-grade cervical disease in women with normal cytology

 

 

The cobas® HPV Test helps you adhere to the guidelines by providing pooled hrHPV results and identifying the individual presence of HPV 16 and HPV 18, the highest-risk genotypes.

Absolute risk of ≥CIN2 stratified by hrHPV status in the ATHENA NILM population5

 

Discover a woman's risk for ≥CIN2 or  find a lab near you that offers the  cobas® HPV Test. 

  • Acronyms:

REFERENCES:

  1. American Society for Colposcopy and Cervical Pathology. HPV Genotyping Clinical Update. http://www.asccp.org/ConsensusGuidelinesHPVGenotypingClinicalUpdate/tabid/5963/Default.aspx. Accessed June 2011.
  2. Stoler MH, Wright TC, Sharma A, et al. High-risk human papillomavirus testing in women with ASC-US cytology: results from the ATHENA HPV study. Am J Clin Pathol. 2011;135(3):468-475
  3. The American Congress of Obstetricians and Gynecologists. ACOG Practice Bulletin. Clinical Management Guidelines for Obstetrician-Gynecologists: Screening for Cervical Cancer. November, 2012
  4. Saslow D et al, Journal of Lower Genital Tract Disease, Volume 16, Number 3, 2012
  5. Wright TC Jr, Stoler MH, Sharma A, Zhang G, Behrens CM, Wright TL. Evaluation of HPV-16 and HPV-18 genotyping for the triage of women with high-risk HPV+ cytology-negative results. Am J Clin Pathol. 2011;136:578-586