Evidence of Decreased Long-term Risk of Cervical Precancer after Negative Primary HPV Screens Compared with Negative Cytology Screens in a Longitudinal Cohort Study.
Cancer Epidemiol Biomarkers Prev
; 33(7): 904-911, 2024 Jul 01.
Article
de En
| MEDLINE
| ID: mdl-38773687
ABSTRACT
BACKGROUND:
The growing use of primary human papillomavirus (HPV) cervical cancer screening requires determining appropriate screening intervals to avoid overtreatment of transient disease. This study examined the long-term risk of cervical precancer after HPV screening to inform screening interval recommendations.METHODS:
This longitudinal cohort study (British Columbia, Canada, 2008 to 2022) recruited women and individuals with a cervix who received 1 to 2 negative HPV screens (HPV1 cohort, N = 5,546; HPV2 cohort, N = 6,624) during a randomized trial and women and individuals with a cervix with 1 to 2 normal cytology results (BCS1 cohort, N = 782,297; BCS2 cohort, N = 673,778) extracted from the provincial screening registry. All participants were followed through the registry for 14 years. Long-term risk of cervical precancer or worse [cervical intraepithelial neoplasia grade 2 or worse (CIN2+)] was compared between HPV and cytology cohorts.RESULTS:
Cumulative risks of CIN2+ were 3.2/1,000 [95% confidence interval (CI), 1.6-4.7] in HPV1 and 2.7/1,000 (95% CI, 1.2-4.2) in HPV2 after 8 years. This was comparable with the risk in the cytology cohorts after 3 years [BCS1 3.3/1,000 (95% CI, 3.1-3.4); BCS2 2.5/1,000 (95% CI, 2.4-2.6)]. The cumulative risk of CIN2+ after 10 years was low in the HPV cohorts [HPV1 4.7/1,000 (95% CI, 2.6-6.7); HPV2 3.9 (95% CI, 1.1-6.6)].CONCLUSIONS:
Risk of CIN2+ 8 years after a negative screen in the HPV cohorts was comparable with risk after 3 years in the cytology cohorts (the benchmark for acceptable risk). IMPACT These findings suggest that primary HPV screening intervals could be extended beyond the current 5-year recommendation, potentially reducing barriers to screening.
Texte intégral:
1
Collection:
01-internacional
Base de données:
MEDLINE
Sujet principal:
Tumeurs du col de l'utérus
/
Infections à papillomavirus
/
Dépistage précoce du cancer
Limites:
Adult
/
Female
/
Humans
/
Middle aged
Pays/Région comme sujet:
America do norte
Langue:
En
Journal:
Cancer Epidemiol Biomarkers Prev
/
Cancer epidemiol. biomark. prev
/
Cancer epidemiology, biomarkers and prevention
Sujet du journal:
BIOQUIMICA
/
EPIDEMIOLOGIA
/
NEOPLASIAS
Année:
2024
Type de document:
Article
Pays d'affiliation:
Canada
Pays de publication:
États-Unis d'Amérique