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Reassurance Against Future Risk of Precancer and Cancer Conferred by a Negative Human Papillomavirus Test

2014; Oxford University Press; Volume: 106; Issue: 8 Linguagem: Inglês

10.1093/jnci/dju153

1460-2105

Julia C. Gage, Mark Schiffman, Hormuzd A. Katki, Paul Castle, Barbara Fetterman, Nicolas Wentzensen, Nancy Poitras, Thomas Lorey, Li C. Cheung, Walter Kinney,

Molecular Biology Techniques and Applications

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.