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J Natl Cancer Inst. 2014 Jul 18;106(8). pii: dju153. doi: 10.1093/jnci/dju153. Print 2014 Aug.

Reassurance against future risk of precancer and cancer conferred by a negative human papillomavirus test.

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  • 1Affiliations of authors: Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, DHHS, Bethesda, MD (JCG, MS, HAK, NW); Global Cancer Initiative, Chestertown, MD (PEC); Regional Laboratory, Kaiser Permanente Northern California, Berkeley, CA (BF, NEP, TL); Information Management Services Inc., Calverton, MD (LCC); Division of Gynecologic Oncology, Kaiser Permanente Medical Care Program, Oakland, CA (WKK). gagej@mail.nih.gov.
  • 2Affiliations of authors: Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, DHHS, Bethesda, MD (JCG, MS, HAK, NW); Global Cancer Initiative, Chestertown, MD (PEC); Regional Laboratory, Kaiser Permanente Northern California, Berkeley, CA (BF, NEP, TL); Information Management Services Inc., Calverton, MD (LCC); Division of Gynecologic Oncology, Kaiser Permanente Medical Care Program, Oakland, CA (WKK).

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.

© Published by Oxford University Press 2014.

Comment in

PMID:
25038467
[PubMed - indexed for MEDLINE]
PMCID:
PMC4111283
[Available on 2015/8/1]
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