• Provencher DM, Murphy KJ. The role of HPV testing. In: Canadian consensus guidelines on human papillomavirus. J Obstet Gynaecol Can 2007 Aug;29(8 Suppl 3):S15-21. [66 references]

This is the current release of the guideline.

The grades of recommendations (A-E and L) and levels of evidence (I, II-1, II-2, II-3, and III) are defined at the end of the "Major Recommendations" field.

1. Reflex human papillomavirus (HPV) DNA testing is recommended only for women aged 30 years or more with atypical glandular cells of undetermined significance (ASCUS) and should be used only as an adjunct to cervical cytology, to reduce the false-positive rate of conventional cytology and increase the negative predictive value of testing. IA
2. There is no indication for HPV testing in women younger than 30 years and therefore it should not be done. IA
3. Because of the high prevalence of high-risk HPV types in women with low-grade squamous intraepithelial lesion (LSIL), high-grade squamous intraepithelial lesion (HSIL), and squamous cell carcinoma (SCC), triage by means of HPV testing should not be done. IA
4. More research should be done to better characterize natural and acquired immunity after HPV infection and vaccination and to redesign screening strategies to focus on identifying women with persistent infection. IIIA

Definitions:

Levels of Evidence*

I: Evidence obtained from at least one properly randomized controlled trial.

II-1: Evidence obtained from well-designed controlled trials without randomization.

II-2: Evidence obtained from well-designed cohort or case–control studies, preferably from more than one center or research group.

II-3: Evidence obtained from comparison between times or places with or without the intervention. Dramatic results in uncontrolled experiments (such as the results of treatment with penicillin in the 1940s) could also be regarded as this type of evidence.

III: Opinions of respected authorities, based on clinical experience, descriptive studies, or reports of expert committees.

*The quality of evidence reported in these guidelines has been adapted from The Evaluation of Evidence criteria described in the Canadian Task Force on Preventive Health Care.

Grades of Recommendations*†

A. There is good evidence to recommend the clinical preventive action

B. There is fair evidence to recommend the clinical preventive action

C. The existing evidence is conflicting and does not allow to make a recommendation for or against use of the clinical preventive action; however, other factors may influence decision-making

D. There is fair evidence to recommend against the clinical preventive action

E. There is good evidence to recommend against the clinical preventive action

I. There is insufficient evidence (in quantity or quality) to make a recommendation; however, other factors may influence decision-making

* Woolf SH, Battista RN, Angerson GM, Logan AG, Eel W. Canadian Task Force on Preventive Health Care. New grades for recommendations from the Canadian Task Force on Preventive Health Care. Can Med Assoc J 2003;169(3):207-8.

† Recommendations included in these guidelines have been adapted from the Classification of Recommendations criteria described in the Canadian Task Force on Preventive Health Care.

None provided

The type of supporting evidence is identified and graded for each recommendation (see "Major Recommendations").

• Provencher DM, Murphy KJ. The role of HPV testing. In: Canadian consensus guidelines on human papillomavirus. J Obstet Gynaecol Can 2007 Aug;29(8 Suppl 3):S15-21. [66 references]

Not applicable: The guideline was not adapted from another source.

2007 Aug

Society of Obstetricians and Gynaecologists of Canada - Medical Specialty Society

The development of this consensus guideline was supported by unrestricted educational grants from Cytyc Canada, Digene Corporation, Graceway Canada, GlaxoSmithKline Inc., Merck Frosst Canada Ltd., and Roche Diagnostics Canada.

HPV Consensus Guidelines Committee

Primary Authors: Diane M. Provencher, MD, FRCSC, Montreal QC and K. Joan Murphy, MD, FRCSC, Toronto ON

Committee Members: Deborah M. Money, MD, FRCSC (Chair) Vancouver BC; Michel Roy, MD, FRCSC (Chair) Quebec City QC; Lisa Allen, MD, FRCSC, Toronto ON; Monica Brewer, MD, Quispamsis NB; Peter Bryson, MD, FRCSC, Kingston ON; Gerald Evans, MD, FRCSC, Kingston ON; Jean-Yves Frappier, MD, FRCSC, Montreal QC; Mary Anne Jamieson, MD, FRCSC, Kingston ON; Charles Lynde, MD, FRCPC, Markham ON; K. Joan Murphy, MD, FRCSC, Toronto ON; Diane M. Provencher, MD, FRCSC, Montreal QC; Michael Shier, MD, FRCSC, Toronto ON; Marc Steben, MD, Montreal QC; Robert Lerch, Public Health Agency of Canada, Ottawa ON; André Lalonde, MD, FRCSC, Executive Vice-President, Ottawa ON; Vyta Senikas, MD, FRCSC, Associate Executive Vice-President, Ottawa ON

Disclosure statements have been received from all members of the committees.

Canadian Association for Adolescent Health - Medical Specialty Society
Canadian Pediatric and Adolescent Gynaecology and Obstetrics Committee - Medical Specialty Society
Federation of Medical Women of Canada - Professional Association
Quebec Association of Pediatricians - State/Local Government Agency [Non-U.S.]
Society of Canadian Colposcopists - Professional Association
Society of Gynecologic Oncologists of Canada - Disease Specific Society

This is the current release of the guideline.

None available

None available

This NGC summary was completed by ECRI Institute on July 6, 2009. The information was verified by the guideline developer on July 14, 2009.

This NGC summary is based on the original guideline, which is subject to the guideline developer's copyright restrictions.