Human papillomavirus testing and the management of women with mildly abnormal cervical smears: an observational study.

Three hundred and thirty three consecutive new patients (aged 17 to 61 years, median 30 years) referred for colposcopy with persistent borderline or mildly dyskaryotic smears and who consented to the study were tested for human papillomavirus (high risk types only) with the Digene Hybrid Capture assay HC II (Abbott Laboratories, Maidenhead), by using cervical brush specimens placed in Digene transport medium, and were treated by large loop excision of the transformation zone. The table summarises test performance, and table A on the BMJ ’s website presents results by age, smear history, and test cut off. Subjects aged under 30 years (166) were more likely than older subjects (167) to test positive for human papillomavirus (79% (131/166) v 45% (75/167); ÷ = 39.4, df = 1, P < 0.001) and (dependent on this) to have cervical intraepithelial neoplasia grade 2 or 3 (high grade disease) (43% (71/ 166) v 27% (45/167); ÷ = 8.5, df = 1, P < 0.01).