Rescreening Practices of Negative Papanicolaou Tests With Positive Human Papillomavirus Test Result

Area of Science:

• Gynecologic cytology
• Molecular pathology
• Public health screening

Background:

• Prospective rescreening of negative for intraepithelial lesion or malignancy (NILM) Papanicolaou (Pap) tests can be enhanced by including high-risk cases.
• High-risk human papillomavirus (HPV) positivity is a criterion for classifying Pap tests as high risk.

Purpose of the Study:

• To evaluate the integration of HPV testing results into the prospective rescreening of NILM Pap tests across diverse laboratories.
• To understand current practices in utilizing HPV status for Pap test follow-up.

Main Methods:

• A questionnaire survey was distributed to laboratories participating in the 2019 College of American Pathologists (CAP) Gynecologic Cytology Program.
• Data were collected from 667 responding laboratories regarding their use of HPV testing in NILM Pap test rescreening.

Main Results:

• A majority of laboratories (59.4%) do not use HPV test results for NILM Pap test rescreening.
• Among laboratories that do use HPV results, policies for rescreening HPV-positive NILM Pap tests vary, involving cytotechnologists, pathologists, or both.
• Reporting practices and the inclusion of consensus recommendations in cytology reports also differ.

Conclusions:

• The College of American Pathologists (CAP) survey highlights current trends in using HPV test results for NILM Pap test rescreening.
• Further quality improvement studies are needed to standardize HPV testing integration in cervical cancer screening protocols.