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Intraoperative Human Papillomavirus Test Predicts 24-Month High-Grade Squamous Intraepithelial Lesion Recurrence
Jordi Rabasa1, Ana Alcalde1, Melissa Bradbury1
1Gynecology Oncology Unit, Department of Gynecology and Obstetrics, Hospital Universitari Vall d'Hebron, Universitat Autónoma de Barcelona, Barcelona, Spain.
Journal of Lower Genital Tract Disease
|June 23, 2020
Summary
An intraoperative human papilloma virus (HPV) test can accurately predict high-grade squamous intraepithelial lesion (HSIL) recurrence after treatment, similar to a test at 6 months. This early detection method may reduce costs and the need for follow-up testing.
Area of Science:
- Gynecology
- Oncology
- Virology
Background:
- Human papilloma virus (HPV) testing is crucial for managing cervical intraepithelial neoplasia (CIN).
- Post-treatment surveillance for high-grade squamous intraepithelial lesion (HSIL) recurrence typically involves HPV testing at 6 months.
- The utility of intraoperative HPV (IOP-HPV) testing for predicting recurrence remains under investigation.
Purpose of the Study:
- To evaluate the diagnostic accuracy of the IOP-HPV test in predicting HSIL recurrence.
- To compare the accuracy of IOP-HPV testing with standard 6-month post-treatment HPV testing.
- To assess the cost-effectiveness of IOP-HPV testing.
Main Methods:
- A prospective cohort study included 304 women treated for HSIL.
- IOP-HPV testing was performed immediately after surgery.
- Patients were followed for 24 months, with comparisons made to 6-month HPV tests and economic analysis.
Main Results:
- The recurrence rate of HSIL was 6.2%.
- IOP-HPV testing demonstrated comparable diagnostic accuracy to 6-month HPV testing for predicting recurrence (e.g., 100% vs. 86.7% sensitivity, 82.0% vs. 77.9% specificity).
- Direct economic savings of €172.8 per patient were identified with IOP-HPV testing.
Conclusions:
- IOP-HPV testing is a reliable method for predicting HSIL recurrence post-treatment.
- This approach offers similar diagnostic accuracy to 6-month HPV testing.
- Implementing IOP-HPV testing can facilitate early detection of recurrence risk and reduce healthcare costs.
