Multimodal hyperspectroscopy as a triage test for cervical neoplasia: Pivotal clinical trial results

•Prospective study effectively demonstrates cervical spectroscopy triage high risk women.•Cervical spectroscopy detected 36.4% more CIN2 + than tests used under current guidelines.•Cervical spectroscopy could reduce unnecessary referrals of women with normal pathology by 40%.

ObjectiveTo prospectively evaluate a new non invasive device that combines fluorescence and reflectance spectroscopy in a population in women at risk for cervical dysplasia.MethodsA total of 1607 women were evaluated with multimodal hyperspectroscopy (MHS), a painless test with extremely high spectral resolution. Subjects who were referred to colposcopy based on abnormal screening tests or other referral criteria underwent the MHS test and also had a sample taken for additional cytology and presence of high risk human papilloma virus (HPV) prior to undergoing biopsy.ResultsSensitivity of MHS for cervical intraepithelial neoplasia (CIN) 2 + was 91.3% (252/276). Specificity, or the potential reduction in referrals to colposcopy and biopsy, was 38.9% (222/570) for women with normal or benign histology and 30.3% (182/601) for women with CIN1 histology. Two year follow-up data, collected for a subgroup of 804 women, revealed 67 interval CIN2 + that originally were diagnosed at enrollment as normal or CIN1. MHS identified 60 of these (89.6%) as positive for CIN2 + prior to their discovery during the two year follow-up period.ConclusionsMHS provides an immediate result at the point of care. Recently, the limitations of cytology have become more obvious and as a consequence greater emphasis is being placed on HPV testing for cervical cancer screening, creating a need for an inexpensive, convenient and accurate test to reduce false positive referrals to colposcopy and increase the yield of CIN2 + at biopsy. MHS appears to have many of the attributes necessary for such an application.