Objective: To determine the incidence of papillomavirus and to asses the role a HPV DNA in screening of cervical intraepithelial neoplasia. Design: Czech National Collaborative Trial Setting: Department of Gynaecology and Obstetrics, Kladno Hospital, Department of Microbiolo- gy, KLINLAB, Prague, outpatient clinics (Kladno, Bruntál, Unhošť) Methods: The study group includes of 3 264 women, their cervical scrapings were sent to KLIN- LAB during November 1996 to June 1998, because of abnormal results of primary screening. Patients with ASCUS, AGNUS, LSIL, HSIL and/or abnormal colposcopic findings were eligible for this study. Only completely filled in records of a subgroup of 1 158 patients were assessed for sensitivity and specificity for CIN in screening methods. Results: The overall sensitivity of cytology and basic colposcopy were 84.7% and 64.9% respective- ly. The overall sensitivity of HPV DNA testing was 66%. The sensitivity of cytology of women with minor cytological abnormities for major cervical disease (CIN 2/3 and microinvasive cancer) in this group of patients was only 35%. Combined cytology with HPV DNA test gave an increased sensitivity for major cervical disease of 83%. Conclusion: 153 (66.4%) of the cervical intraepithelial neoplasias grade 2/3 displayed negative and borderline or mild cytological changes. The combined use of cytology with HPV testing increased the sensitivity with a reduction of specificity. However, it is evident from these results that HPV DNA testing alone cannot be used as a diagnostic tool but could usefully improve the level of screening CIN in common clinical practice.

        Key words: HPV test, clinical practice