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• W2165412776 abstract "<b>Objectives</b> To assess whether the increased sensitivity of screening for human papillomavirus (HPV) may represent overdiagnosis and to compare the long term duration of protective effect against cervical intraepithelial neoplasia grade 2 or worse (CIN2+) in HPV based and cytology based screening. <b>Design</b> 13 year follow-up of the Swedescreen randomised controlled trial of primary HPV screening. <b>Setting</b> Organised cervical screening programme in Sweden. <b>Participants</b> 12 527 women aged 32-38 attending organised screening were enrolled and randomised to HPV and cytology double testing (intervention arm, n=6257) or to cytology only, with samples frozen for future HPV testing (control arm, n=6270). <b>Main outcome measures</b> Cumulative incidence of CIN2+ and CIN3+ (Kaplan Meier curves). Longitudinal test characteristics were calculated for cytology only, HPV testing only, and cytology and HPV testing combined, adjusting for censoring. <b>Results</b> The increased detection of CIN2+ in the intervention arm decreased over time. After six years, the cumulative incidence of CIN3+ was similar in both trial arms, and after 11 years the cumulative incidence of CIN2+ became similar in both arms. The longitudinal sensitivity of cytology for CIN2+ in the control arm at three years was similar to the sensitivity of HPV testing in the intervention arm at five years of follow-up: 85.94% (95% confidence interval 76.85% to 91.84%) <i>v</i> 86.40% (79.21% to 91.37%). The sensitivity of HPV screening for CIN3+after five years was 89.34% (80.10% to 94.58%) and for cytology after three years was 92.02% (80.59% to 96.97%). <b>Conclusions</b> Over long term follow-up, the cumulative incidence of CIN2+ was the same for HPV screening and for cytology, implying that the increased sensitivity of HPV screening for CIN2+ reflects earlier detection rather than overdiagnosis. The low long term risks of CIN3+ among women who tested negative in HPV screening, support screening intervals of five years for such women. <b>Trial registration</b> Clinicaltrials.gov NCT00479375." @default.
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• W2165412776 date "2014-01-16" @default.
• W2165412776 modified "2023-10-07" @default.
• W2165412776 title "Long term duration of protective effect for HPV negative women: follow-up of primary HPV screening randomised controlled trial" @default.
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• W2165412776 doi "https://doi.org/10.1136/bmj.g130" @default.
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