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Cervical Threats May Arrive Without Human Papillomavirus

Study found small number of CIN-3 diagnoses following high-risk HPV-negative tests

THURSDAY, April 3 (HealthDay News) -- Out of any sizeable population, the occasional woman with cervical precancer will test negative for high-risk human papillomavirus (HPV) for a variety of possible reasons, according to research published in the April issue of Obstetrics & Gynecology.

Philip E. Castle, Ph.D., of the National Cancer Institute in Bethesda, Md., and colleagues analyzed data from 621 cases of cervical intraepithelial neoplasia-grade 3 (CIN-3), which is almost always caused by high-risk HPV, for which women are usually positive several years before diagnosis. The data came from the two-year ASCUS LSIL Triage Study.

Thirty-three women with CIN-3 were negative for high-risk HPV at baseline, and 588 were positive, the researchers report. Upon reviewing the case histories of the 33 negative cases, the investigators found reason to believe that 12 were new cases, eight were due to misclassified histology, eight were false-negative high-risk HPV, and five were due to non-high-risk HPV.

"The high-risk HPV-negative CIN-3 cases that are the result of misclassified histology do not truly represent CIN-3 and…are clinically relevant only with respect to possible overtreatment. Similarly, cases due to low-risk HPV genotypes are unlikely to develop into invasive cancer. Of the remaining high-risk HPV-negative CIN-3 cases, five were attributable to false-negative high-risk HPV and 12 to incident cases. Most women would have been diagnosed during follow-up with adherence to current guidelines," the authors write.

One study co-author was a consultant for Digene Corporation, and another is a consultant with Roche Molecular Diagnostics, manufacturer of the test used in the study.

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