Evaluation of folate receptor-mediated tumor detection as a triage tool in cervical cancer screening.

OBJECTIVE To evaluate the efficacy of folate receptor-mediated tumor detection (FRD) for identifying high-grade intraepithelial squamous lesions (HSIL) in the triage of women who are positive for human papillomavirus (HPV), and those with cytology findings of atypical squamous cells of undetermined significance (ASCUS). METHOD A secondary analysis of prospectively collected data from 1504 women who had abnormal results during primary cervical cancer screening at 13 hospitals in Beijing, China, between November 2014 and August 2015. The detection accuracy of FRD was evaluated among HPV-positive women and women with ASCUS referred for colposcopy examination. RESULTS Among 1338 women with HPV, the percentage coincidence with pathology findings was higher for FRD (66.67%) than for cytology of ASCUS or higher (51.49%). The rate of colposcopy referral for cytology and FRD as a triage tool was 969 (72.4%) and 736 (55.0%), respectively. Thus, 233 (17.4%) fewer women would be referred for colposcopy by FRD. Among 476 women with cytology of ASCUS, the percentage coincidence with pathology findings was higher for FRD (63.45%) than for HPV (35.9%). CONCLUSION FRD was found to be a promising triage tool for women who are HPV-positive and those with cytology findings of ASCUS.