The addition of p16/Ki-67 to HPV testing leads to more accurate stratification of minor cervical abnormalities

CERVIVA researchers have recently published significant findings on the triage of minor abnormal cervical cytology, LSIL and ASCUS. In recent years there has been widespread implementation of HPV testing as part of cervical screening and triage of minor cervical abnormalities. However, due to the nature of HPV infections, HPV DNA testing can still lead to a high number of women being referred to colposcopy. The aim of this paper was to expand the knowledge of existing HPV-based tests by investigating more specific methods that may highlight those women at true risk of high grade cervical pre-cancer.

The paper, published in Cytopathology, provides a systematic analysis of the clinical performance of a HPV DNA based test and p16/Ki-67 test in the triage of minor cervical abnormalities. The study was conducted on a population of 471 women with minor abnormal cervical cytology attending a colposcopy clinic. Our findings, based on longitudinal data [up to 2 years], revealed that combined HPV DNA and p16/Ki-67 testing has the potential to introduce further stratification of minor cervical abnormalities. By using both tests in combination we identified a possible 35% reduction in the number of women that would have to attend colposcopy.

While adding an additional test to screening may be more costly, introducing further stratification of minor abnormalities, prior to colposcopy rather than at colposcopy, should reduce unnecessary workup and treatment.This will benefit women by reducing the psychosocial effects endured from having repeat abnormal smears and attending colposcopy clinics.The findings of this work have the potential to advocate consideration of future large scale trails in the clinical practice and management in cervical screening.