Reassurance Against Future Risk of Precancer and Cancer Conferred by a Negative Human Papillomavirus Test
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Open Access
- 3 June 2014
- journal article
- research article
- Published by Oxford University Press (OUP) in JNCI Journal of the National Cancer Institute
- Vol. 106 (8), dju153
- https://doi.org/10.1093/jnci/dju153
Abstract
Primary human papillomavirus (HPV) testing (without concurrent Pap tests) every 3 years is under consideration in the United States as an alternative to the two recommended cervical cancer screening strategies: primary Pap testing every 3 years, or concurrent Pap and HPV testing (“cotesting”) every 5 years. Using logistic regression and Weibull survival models, we estimated and compared risks of cancer and cervical intraepithelial neoplasia grade 3 or worse (CIN3+) for the three strategies among 1011092 women aged 30 to 64 years testing HPV-negative and/or Pap-negative in routine screening at Kaiser Permanente Northern California since 2003. All statistical tests were two sided. Three-year risks following an HPV-negative result were lower than 3-year risks following a Pap-negative result (CIN3+ = 0.069% vs 0.19%, P < .0001; Cancer = 0.011% vs 0.020%, P < .0001) and 5-year risks following an HPV-negative/Pap-negative cotest (CIN3+ = 0.069% vs 0.11%, P < .0001; Cancer = 0.011% vs 0.014%, P = .21). These findings suggest that primary HPV testing merits consideration as another alternative for cervical screening.Keywords
This publication has 13 references indexed in Scilit:
- Efficacy of HPV-based screening for prevention of invasive cervical cancer: follow-up of four European randomised controlled trialsThe Lancet, 2013
- 2012 Updated Consensus Guidelines for the Management of Abnormal Cervical Cancer Screening Tests and Cancer PrecursorsJournal of Lower Genital Tract Disease, 2013
- Five-Year Risks of CIN 3+ and Cervical Cancer Among WomenWho Test Pap-Negative But Are HPV-PositiveJournal of Lower Genital Tract Disease, 2013
- Five-Year Risks of CIN 2+ and CIN 3+ Among Women With HPV-Positive and HPV-Negative LSIL Pap ResultsJournal of Lower Genital Tract Disease, 2013
- Benchmarking CIN 3+ Risk as the Basis for Incorporating HPV and Pap Cotesting into Cervical Screening and Management GuidelinesJournal of Lower Genital Tract Disease, 2013
- Screening for Cervical Cancer: U.S. Preventive Services Task Force Recommendation StatementAnnals of Internal Medicine, 2012
- Cervical cancer risk for women undergoing concurrent testing for human papillomavirus and cervical cytology: a population-based study in routine clinical practiceThe Lancet Oncology, 2011
- Performance of high-risk human papillomavirus DNA testing as a primary screen for cervical cancer: a pooled analysis of individual patient data from 17 population-based studies from ChinaThe Lancet Oncology, 2010
- HPV Screening for Cervical Cancer in Rural IndiaNew England Journal of Medicine, 2009
- Long term predictive values of cytology and human papillomavirus testing in cervical cancer screening: joint European cohort studyBMJ, 2008