Correlation of histopathology of patients with negative human papillomavirus (Hpv) and high-grade liquid-based cytology results following introduction of primary Hpv cervical screening in Australia

Abstract

Aim: The study correlates histopathology in patients with negative human papillomavirus (HPV) and high-grade liquid-based cytology (LBC) testing following the introduction of primary HPV screening for cervical cancer in Australia. Methods: Retrospective audit of cervical samples submitted to Capital Pathology, ACT, between 1 December 2017 and 30 April 2019. HPV testing performed by Roche Cobas 6800 (Roche Diagnostics). HPV and LBC results, patient age and histopathology follow-up within 6 months of cytology was documented. Low grade cytology included low-grade intraepithelial lesion (LSIL) and possible LSIL. High-grade included all other abnormal cytology results. Results: A total of 365 cases of HPV-negative, abnormal cytology were identified: 297 of 365 (81.4%) were low-grade and 68 of 385 (18.6%) were high-grade. 14 of 68 (20.5%) cases with HPV-negative and high-grade cytology had histopathology within 6 months: 3 endometrioid adenocarcinoma, 2 endometrial malignancy, 1 adenocarcinoma (endocervical), 2 serous adenocarcinoma, 2 squamous cell carcinoma, 3 high-grade intraepithelial lesion (HSIL) and 1 adenosquamous carcinoma. The median age was 64 years. Discussion: This study identified 14 patients with HPV-negative, high-grade cytology confirmed on histopathology. This data may support co-testing of patients in their sixth decade as an alternative to primary HPV testing.