Testing for high-risk (HR) human papillomavirus (HPV) is a key component of current recommendations for cervical cancer screening. Herein is described our clinical experience using Cervista HPV HR, a testing platform recently approved by the USThe relationship of cervical cancer and cervical intraepithelial neoplasia grades 2 and 3 to persistent infection with human papillomavirus (HPV) is well established. Since the identification of HPV as the primary etiologic agent of cervical cancer, 1 14 sexually transmitted oncogenic variants have been identified. These variants, referred to as the high-risk subtypes (HPV 16,18,31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, and 68), are responsible for most cervical cancers worldwide. [2][3][4] The remarkable success of Papanicolaou test-based cervical cancer screening programs demonstrates that cervical cancer is largely preventable. However, despite its many advantages and historical success, morphologic examination of cervical cytologic material alone has limitations as a screening test. The addition of high-risk HPV (HR-HPV) DNA testing to screening algorithms has enabled better identification of clinically significant precancerous cervical lesions and more accurate evaluation of the risk of developing cervical cancer. 5,6 HR-HPV DNA testing is currently recommended by the American Society for Colposcopy and Cervical Pathology screening guidelines in two principal clinical settings. One setting in which HR-HPV DNA testing is beneficial is when cytologic findings are ambiguous or equivocal. HR-HPV DNA testing for triage of patients with atypical squamous cells of undetermined significance (ASC-US) cytological interpretations decreases colposcopic referrals by roughly half without sacrificing screening sensitivity. 7 A second setting in which HR-HPV testing is useful is for primary screening ("co-testing," along with cytology) in patients aged 30 years or older. Women in this group with both normal cytological interpretations (ie, negative for intraepithelial lesion or malignancy [NILM]) and negative HR-HPV test results are at extremely low risk of developing cervical cancer over the next several years. 8 Accordingly, the current
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