HPV-positive women with normal cytology remain at increased risk of CIN3 after a negative repeat HPV test

• Published in: British journal of cancer Vol. 117; no. 10; pp. 1557 - 1561
• Main Authors: Polman, Nicole J, Veldhuijzen, Nienke J, Heideman, Daniëlle A M, Snijders, Peter J F, Meijer, Chris J L M, Berkhof, Johannes
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 07.11.2017; Nature Publishing Group
• Subjects: 692/53; 692/699/67/1517/1371; 692/700/1538; Adult; Biomedical and Life Sciences; Biomedicine; Cancer Research; Cellular biology; Cervical Intraepithelial Neoplasia - virology; Cytology; Drug Resistance; Epidemiology; Female; Health risk assessment; Health risks; Histology; Human papillomavirus; Humans; Infections; Medical screening; Middle Aged; Molecular Medicine; Oncology; Papillomaviridae; Papillomavirus Infections - complications; Papillomavirus Infections - diagnosis; Risk Factors; Uterine Cervical Neoplasms - virology; human papillomavirus (HPV); triage testing; cervical screening; HPV infection risk; repeat HPV testing; cervical intraepithelial neoplasia (CIN)
• ISSN: 0007-0920; 1532-1827
• DOI: 10.1038/bjc.2017.309

Background: In human papillomavirus (HPV)-based screening, a repeat HPV test is often recommended for HPV-positive women with normal cytology (HPV-pos/cyt-neg), but its absolute risk of cervical precancer (CIN3+) 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 (double negatives) in the POBASCAM cohort. We obtained histology data from the Dutch pathology registry (PALGA). Results: Human papillomavirus infection risk was 20.4% (19 of 93) in HPV-pos/cyt-neg, repeat HPV-negative women and 3.2% (294 of 9186; P <0.001) in double negatives. Corresponding CIN3+ risks were 2.0% (4 of 199) and 0.2% (41 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.