Population-based cervical cancer screening using high-risk HPV DNA test and liquid-based cytology in Northern Thailand

Abstract

Background Combined high-risk HPV (hrHPV) DNA testing and cytology (co-testing) has increasingly gained acceptance in cervical cancer screening. This study was aimed to evaluate the performance of cytology and hrHPV test in population-based samples from women in northern Thailand. Methods Cervical samples were collected for hybrid capture 2 (HC2) testing and liquid-based cytology from women aged 30-60 years who were residents in Chiang Mai, northern Thailand, between May and September 2011. Women with positive cytology were referred for colposcopy, while women with positive HC2 only were followed for 2 years. Results Of 2752 women included in this study, 3.0% had positive both tests, 4.1% had positive HC2 only, and 1.3% had positive cytology only. At baseline screening, positive HC2 was observed in 70.6% among cytology-positive women compared with 4.3% among cytology-negative women. High-grade squamous intraepithelial lesion or worse lesions were histologically detected in 23.5% of women with positive baseline cytology and in 9.8% of women with positive baseline HC2 only on follow-up. Conclusions hrHPV test is superior to cytology in the early detection of histologic HSIL+ lesions. In northern Thailand, hrHPV testing has a potential to be used as a primary screening test for cervical cancer.