Posttreatment human papillomavirus testing for recurrent cervical intraepithelial neoplasia: a systematic review

Am J Obstet Gynecol. 2009 Apr;200(4):422.e1-9. doi: 10.1016/j.ajog.2008.11.031. Epub 2009 Jan 24.

Abstract

Objective: We conducted a systematic review to evaluate the characteristics of human papillomavirus testing, particularly Hybrid Capture 2, in follow-up evaluations after treatment for cervical intraepithelial neoplasia for the detection of residual or recurrent cervical intraepithelial neoplasia grade >/= 2.

Study design: Medline was searched for relevant studies that were published between 1992 and September 2007. Of the 1107 citations that were identified, 20 articles met the inclusion criteria.

Results: Studies that used polymerase chain reaction testing were too heterogeneous to combine. We identified 5 studies that performed both Hybrid Capture 2 and colposcopy. Pooled sensitivity for Hybrid Capture 2 was 90.7% (95% CI, 75.4-96.9%), and pooled specificity was 74.6% (95% CI, 60.4-85.0%). Pooled sensitivity for cervical cytologic testing was 76.6% (95% CI, 62.0-86.8%), and pooled specificity was 89.7% (95% CI, 22.7-99.6%).

Conclusion: Hybrid Capture 2 testing can identify approximately 91% of women with residual or recurrent cervical intraepithelial neoplasia grade >/= 2; however, approximately 30% of women would undergo colposcopy in follow-up evaluation.

Publication types

  • Research Support, N.I.H., Extramural
  • Review
  • Systematic Review

MeSH terms

  • Colposcopy
  • Female
  • Follow-Up Studies
  • Humans
  • Neoplasm Recurrence, Local / diagnosis*
  • Neoplasm Recurrence, Local / virology*
  • Papillomaviridae / isolation & purification*
  • Uterine Cervical Dysplasia / diagnosis*
  • Uterine Cervical Dysplasia / virology*
  • Uterine Cervical Neoplasms / diagnosis*
  • Uterine Cervical Neoplasms / virology*
  • Virology / methods