Cervical screening

TDL’s Cytology Laboratory provides a rapid service for liquid based cervical samples from all sectors of practice – health screening, occupational Health, GPs, consultants, colposcopy units, clinics, hospitals and other laboratories.

Human papillomavirus (HPV) is a common virus which infects the skin and may be transmitted through sexual contact. There are over 200 types of HPV which are split into two groups depending on whether they are linked to an increased risk of cervical cancer. These are described as high risk HPV subtypes or low risk HPV subtypes.

Infection with a high-risk HPV (hrHPV) has been established as a necessary cause of cervical cancer. This has led in recent years to the inclusion of hrHPV testing as an adjunct to cervical cytology in organised cervical screening programmes.

Compared to cervical cytology, hrHPV testing has been shown to reduce the risk of developing cervical cancer through increased sensitivity. The high negative predictive value of hrHPV testing and lower false negative rate provides assurance to woman and clinicians that the risk of developing cervical cancers between screening tests, is rare.

What does this change mean?

It means that HPV testing is the FIRST LINE TEST. It will be carried out as a single test, with a single result reported as Detected/Not Detected.

• If HR-HPV is NEGATIVE (Not Detected) – this means no further testing is needed for your patient and they may return to Routine Recall.
• If HR-HPV is POSITIVE (Detected) – this means that CYTOLOGY will be processed from the same ThinPrep Vial. A further specimen is not required. Patient recall (management) will be determined by the individual screening history and current test results.

All TDL requests for HPV are processed as follows:

• If HPV is requested as a single test and the result is Negative/Not Detected, cervical cytology (PAPT) would only be processed if specifically requested. Should HPV and PAPT be undertaken, there would be a charge for both the HPV and the PAPT. 
• If the HPV result is HR-HPV Detected, cervical cytology (PAPT) will be processed, even if the PAPT has not been requested. The PAPT will not be charged.