Clinical Utility of Adjunctive High-Risk Human Papillomavirus DNA Testing in Women with Papanicolaou Test Findings of Atypical Glandular Cells (Report‪)‬

A typical glandular cell (AGC) interpretations (1-2) and screening for glandular cervical neoplasia (3-7) remain some of the major challenges in gynecologic cytopathology. Even though most Papanicolaou (Pap) tests with AGC findings turn out to reflect a variety of underlying benign conditions, (8-10) a significant subset of AGC cases reflect underlying cervical intraepithelial neoplasia (CIN) grades 2/3 and/or endocervical adenocarcinoma in situ (AIS) as well as occasional cases of invasive cervical and noncervical carcinoma. (11-20) Cervical glandular cancers remain a major challenge to cervical cancer prevention efforts in the United States because cervical glandular cancers continue to increase even as squamous carcinomas have experienced an accelerated decline since the advent of liquid-based cytology. (21,22) The low incidence of AGC Pap test results (23) to date has limited our understanding of how best to integrate high-risk human papillomavirus (hrHPV) testing into AGC follow-up algorithms. Nevertheless, several series examining possible roles for hrHPV testing in patients with AGC Pap test results are accumulating. (24-37) Accordingly, we sought to analyze our histologic follow-up results for women with AGC Pap test findings and available hrHPV test results in a large, integrated, academic health system that was a participant in the atypical squamous cells of undetermined significance (ASC-US)/low-grade squamous intraepithelial lesion triage study (38) and an early adopter of widespread adjunctive hrHPV testing.