HPV co-testing as cervical screening test, Experience of Alweiya early detection cervical clinic: one-year Analysis

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Objectives: The high-risk Human papilloma virus test with conventional cytology (HPVco-test) was firstly introduced in our institute at May 2019 so we aimed to estimate the prevalence of abnormal cytology and positive high-risk human papillomavirus test results in a screening woman and to assess the accuracy between cytology and Human papilloma virus testing to evaluate the feasibility of integrating the latter as a primary test in the national cervical cancer screening program.
 Methods: A prospective study for women attending to early detection cervical clinic, during the period from May 2019 to May 2020. Patients who were sexually active were included in the study. Samples for conventional cytology and HPV by using real-time polymerase chain reaction technique for high risk types were taken concurrently. The prevalence of positive screening results and the difference in accuracy between two testing were estimated by McNemar’s χ2 test.
 Result: A total of 388 women were included in the study. The prevalence of positive test for hr-HPV was 2.1%(8) while the prevalence of abnormal cytology test was 19.1%(74), Concerning discordant pairs, 0.8%(3) of women had normal cytology with a positive hr-HPV test result and 17.8%(69) of women had abnormal cytology with a negative hr-HPV test result. A total of 311 (80.1%) women had normal cytology and negative hr-HPV test results. The proportion of women with abnormal cytology and positive hr-HPV test results was 1.3% (5 women). the difference in accuracy between the two results was statistically significant (<0.0001). The prevalence of positive hr-HPV test decreased with increasing age, whereas the prevalence of abnormal cytology showed a bimodal age pattern.
 Conclusion: The prevalence of abnormal cytology was high to that of hr-HPV testing, which could not allow for the implementation of hr-HPV as a primary test in the national screening program in Iraq.