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BMJ. 2008 Oct 13;337:a1754. doi: 10.1136/bmj.a1754.

Long term predictive values of cytology and human papillomavirus testing in cervical cancer screening: joint European cohort study.

Author information

1
Lund University, Medical Microbiology, University Hospital MAS, 205 02 Malmö, Sweden. joakim.dillner@med.lu.se

Abstract

OBJECTIVE:

To obtain large scale and generalisable data on the long term predictive value of cytology and human papillomavirus (HPV) testing for development of cervical intraepithelial neoplasia grade 3 or cancer (CIN3+).

DESIGN:

Multinational cohort study with joint database analysis.

SETTING:

Seven primary HPV screening studies in six European countries.

PARTICIPANTS:

24,295 women attending cervical screening enrolled into HPV screening trials who had at least one cervical cytology or histopathology examination during follow-up.

MAIN OUTCOME MEASURE:

Long term cumulative incidence of CIN3+.

RESULTS:

The cumulative incidence rate of CIN3+ after six years was considerably lower among women negative for HPV at baseline (0.27%, 95% confidence interval 0.12% to 0.45%) than among women with negative results on cytology (0.97%, 0.53% to 1.34%)). By comparison, the cumulative incidence rate for women with negative cytology results at the most commonly recommended screening interval in Europe (three years) was 0.51% (0.23% to 0.77%). The cumulative incidence rate among women with negative cytology results who were positive for HPV increased continuously over time, reaching 10% at six years, whereas the rate among women with positive cytology results who were negative for HPV remained below 3%.

CONCLUSIONS:

A consistently low six year cumulative incidence rate of CIN3+ among women negative for HPV suggests that cervical screening strategies in which women are screened for HPV every six years are safe and effective.

PMID:
18852164
PMCID:
PMC2658827
DOI:
10.1136/bmj.a1754
[Indexed for MEDLINE]
Free PMC Article

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