Cytology and Cervicography Compared to Cytology Alone for Human Papillomavirus Detection

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Abstract
This retrospective study compared cervicography and cytology versus cytologic screening alone for the detection of cervical and vaginal human papillomavirus (HPV) infections. Six hundred seventy-three patients were evaluated by both Pap smears and cervicography. Eighteen of 673 Pap smears showed evidence of HPV, a 2.7% incidence of HPV detected by Pap smear. Two hundred ninety-two patients were referred for colposcopic examination because of suspicious cervigrams. One hundred one of the colposcoped patients underwent colposcopically directed biopsy. The cervigram was interpreted as positive for HPV in 45 of these patients. Fifty-two (51%) of the 101 patients biopsied had histologic evidence of an HPV infection. Only 8 (15%) of these 52 patients with biopsy-proven HPV had evidence of HPV on their Pap smears. Nearly three times as many patients were found to have HPV by cervigram as by Pap smears (McNemar's test, P < 0.001). The addition of cervicography to the cervical screening procedure increased the HPV detection rate to 7.7% (52/673). It is our conclusion that cervicography may be a useful additional screening technique for the detection of patients at increased risk for cervical HPV infections.