Valutazione del ruolo dell’HPV-DNA test nei programmi di prevenzione del cancro cervicale

Human Papillomavirus (HPV) infection is the main cause of cervical cancer and cervical intraepithelial neoplasia (CIN) worldwide. Consequently, it would be useful to evaluate HPV testing to screen for cervical cancer. Recently several molecular biological tests able to detect different HPV types and to divide into high and lowrisk group have been developed. In this study we examined HPV prevalence and genotype distribution in a group of 446 women and evaluated the role of HPV-DNA testing in cervical screening programs. HPV detection and genotyping were done using a polymerase chain reaction based assay (HPV Typing test). One hundred and fiftythree of those women had HPV infection (34.5% of the patients); 23 (15%) had low cancerrisk HPV DNA (LR); 116 (75.8%) had hight-risk HPV types (HR) and 14 (9%) from both groups. 130 women (85%) in this HPV-infected group had at least one high risk HPV type, and were therefore considered to be at high risk for cancer. PCR results were not completely comparable with cytological diagnosis. We conclude that a combination of HPV DNA and cytologic testing has almost 100% sensitivity and negative predictive value. The specificity of the combined test is slightly lower than the specificity of the Pap-test alone but this decrease could potentially be offset by a greater protection from neoplastic progression and cost savings available by extended screening intervals.