The value of human papillomavirus testing in the colposcopy clinic

The aim of the study was to investigate if human papillomavirus (HPV) testing can help in treatment and management decision-making in patients referred to the colposcopy clinic with mildly dyskaryotic or borderline smears. Fifty-five patients referred to the colposcopy clinic in Benenden Hospital with mildly dyskaryotic or borderline smears had HPV testing in addition to colposcopy. Twenty-eight patients had a negative HPV test and normal colposcopy and were discharged back to their general practitioners for cytological surveillance. The most recent smear results of these 28 patients were obtained from their general practitioners to assess if any patient had progressed to a higher-grade smear. Twenty-one (75%) replies were obtained and in 17 (80.9%) patients smear results had regressed to normal. Three continued to have borderline or mildly dyskaryotic smear and one had progressed to moderate dyskaryosis. Our conclusion was that in the presence of normal colposcopic findings in patients with mildly dyskaryotic or borderline smears, negative HPV status justifies referral back to the general practitioner for cytological surveillance, thus reducing workload and cost.