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• W2732959750 abstract "A main challenge of human papilloma (HPV)‐based screening for cervical cancer is to adequately identify HPV‐positive women at highest risk of cervical intraepithelial neoplasia grade 3 or worse, CIN3+. The prognostic value of currently used adjunct markers (HPV16/18 genotyping and reflex cytology) may change after multiple rounds of HPV‐based screening because of a change in the proportion of HPV‐positive women with incident infections. To this end, we re‐analyzed results from the POBASCAM trial (Population Based Screening Study Amsterdam). Women were randomized to HPV/cytology cotesting (intervention group) or to cytology‐only (HPV blinded; control group) at enrolment. Our analytical population consisted of women with an HPV‐positive result at the second round, 5 years after enrolment ( n = 381 intervention, n = 392 control). Nine‐year CIN3+ risks were estimated by Kaplan–Meier. HPV‐positive women were stratified by risk markers: HPV16/18 genotyping, reflex cytology and preceding HPV results. When comparing one to two rounds of HPV‐based screening, the prognostic value of an abnormal cytology result did not change (40.0% vs . 42.3%, p = 0.5617), but diminished for an HPV16/18 positive result (25.4% vs . 38.0%, p = 0.0132). HPV16/18 genotyping was nondiscriminative in women with incident HPV infections (HPV16/18 positive 10.0% vs . negative 12.1%, p = 0.3193). Women from the intervention group were more likely to have incident infections compared to women from the control group (incident screen‐positive results 75.6% vs . 64.6%, p = 0.001) Our results indicate that at a second round of HPV‐based screening, risk differentiation by cytology remained strong, but was diminished for HPV 16/18 genotyping because of a larger proportion of incident infections." @default.
• W2732959750 created "2017-07-14" @default.
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• W2732959750 date "2017-07-18" @default.
• W2732959750 modified "2023-10-16" @default.
• W2732959750 title "Stratifying HPV‐positive women for CIN3+ risk after one and two rounds of HPV‐based screening" @default.
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• W2732959750 doi "https://doi.org/10.1002/ijc.30865" @default.
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