SANE Vax, Inc.
By Norma Erickson
March 27, 2011
HPV Genotyping Clinical Update
National Cancer Institute studies have shown that women with HPV types 16 and 18 have about a 20% risk of progressing to CIN3 over 10 years despite negative Pap tests, and colposcopy may be useful for these women. However, most HPV 16/18 infections regress, especially in women under age 30, who also have almost a 20% rate of high risk HPV infection. The 2006 Consensus Guidelines included a statement that in cytology negative women ages 30 years and older who are high-risk HPV DNA positive it would be reasonable to obtain genotyping assays for HPV 16 and 18. Women who were positive should be referred for immediate colposcopy, while those who are HPV 16/18 negative but positive for other high-risk types should be followed with repeat cytology and high-risk HPV testing in 12 months. Because a FDA-approved HPV genotyping assay was not available in 2006, this recommendation was made contingent on approval of such an assay. The first HPV genotyping assay was approved in March 2009 and based on this approval ASCCP released the Management Algorithm for Using HPV Genotyping to Manage HPV High-risk Positive / Cytology Negative Women 30 Years and Older. Note that it is also reasonable to manage women who are Pap negative but high-risk HPV positive by repeating both tests in 12 months. Genotyping assays are not suitable for women who are younger than 30 years old. Genotyping is inappropriate for women with abnormal Pap results, as results do not alter management.
[Note from SaneVax: Although the statements included in the above referenced ‘guidelined’ are accurate, they are put forth in a manner that is quite confusing. It clearly states that women under 30 only have a 20% chance of infection with a high-risk genotype of HPV. Should you develop abnormal cervical cells (CIN 1 or CIN2) from exposure to these high risk strains, the ‘guidelines’ state you only have a 20% chance of these cells progressing to CIN3 over a period of 10 years. That would make the chances of progression to cancer quite minimal.