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

Joint European Cohort Study

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    337 Citations (Scopus)

    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.

    Original languageEnglish
    Pages (from-to)a1754
    JournalBMJ (Online)
    Volume337
    DOIs
    Publication statusPublished - 13 Oct 2008

    Keywords

    • Cervical Intraepithelial Neoplasia/diagnosis
    • Cohort Studies
    • Cytological Techniques
    • Europe/epidemiology
    • Female
    • Humans
    • Incidence
    • Kaplan-Meier Estimate
    • Mass Screening
    • Papillomavirus Infections/diagnosis
    • Predictive Value of Tests
    • Prospective Studies
    • Uterine Cervical Neoplasms/diagnosis
    • Vaginal Smears

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