Journal
BRITISH JOURNAL OF CANCER
Volume 117, Issue 10, Pages 1557-1561Publisher
SPRINGERNATURE
DOI: 10.1038/bjc.2017.309
Keywords
cervical screening; human papillomavirus (HPV); cervical intraepithelial neoplasia (CIN); triage testing; repeat HPV testing; HPV infection risk
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Funding
- Netherlands Organisation for Health Research and Development (Zorg Onderzoek Nederland) [30-05220]
- EC FP7 Health Innovation 1 CoheaHr [603019]
- ZonMW [531002007]
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Background: In human papillomavirus 9HPV)-based screening, a repeat HPV test is often recommended for HPV-positive women with normal cytology 9HPV-pos/cyt-neg), but its absolute risk of cervical precancer 9CIN3+) over two screening rounds needs to be assessed. Methods: We compared the 5-year risk of HPV infection and CIN3+ in HPV-pos/cyt-neg women with a negative repeat HPV test to the risk in HPV-negative women with normal cytology 9double negatives) in the POBASCAM cohort. We obtained histology data from the Dutch pathology registry 9PALGA). Results: Human papillomavirus infection risk was 20.4% 919 of 93) in HPV-pos/cyt-neg, repeat HPV-negative women and 3.2% 9294 of 9186; P<0.001) in double negatives. Corresponding CIN3+ risks were 2.0% 94 of 199) and 0.2% 941 of 18 562; P<0.001). Infection risks were also increased in type-specific analyses of HPV16, 31, 33, 39, 52, 56 and 58. Conclusions: HPV-pos/cyt-neg women continue to have an increased CIN3+ risk, also when the repeat HPV test is negative. Therefore, intervals in primary HPV screening should be determined separately for HPV-positive and -negative women.
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