Clinical study of the value of Human Papillomavirus (HPV) genotyping in the treatment of serial abnormal cervical cytology Pap 2/3a mild dyskaryosis (Pap 3a1): consequences for referral and treatment.
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According to the guidelines of the cervical cancer screening program women with repeated Pap 2/Pap 3a1 (borderline to mild abnormal cervical cytology) should be referred to the gynaecologist for further examination. In many women this referral is unnecessary because they will never develop cervical cancer. From various studies we know that an infection with a high-risk Human Papillomavirus type (hr HPV) is needed for development and progression of cervical dysplasia. Without this virus women will not develop cervical cancer. Although hr HPV is necessary for development of cervical cancer, only a small proportion of women infected with hr HPV will contract it: most women with hr HPV are able to clear the infection. Clearance of hr HPV will result in regression of the cervical lesion. The prevalence of hr HPV in women with Pap 2/3a1 is 11 and 65%, respectively. To prevent unnecessary referrals, treatment and reduce health care costs we study the utility of hr HPV testing in the triage of women with repeated Pap 2/3a1.