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Cancer cytopathology
Aug, 2017;125 (8): 644-651.

Three-year risk of high-grade CIN for women aged 30 years or older who undergo baseline Pap cytology and HPV co-screening.

Ming Guo, Abha Khanna, Jianping Wang, Marilyn A Dawlett, Teresa L Kologinczak, Genevieve R Lyons, Roland L Bassett, Nour Sneige, Yun Gong, Therese B Bevers
Author Information
  1. Ming Guo: Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas. ORCID
  2. Abha Khanna: Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
  3. Jianping Wang: Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
  4. Marilyn A Dawlett: Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
  5. Teresa L Kologinczak: Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
  6. Genevieve R Lyons: Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas.
  7. Roland L Bassett: Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas.
  8. Nour Sneige: Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
  9. Yun Gong: Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
  10. Therese B Bevers: Cancer Prevention Center, The University of Texas MD Anderson Cancer Center, Houston, Texas.
PMID: 28498639 DOI: 10.1002/cncy.21877

Abstract

BACKGROUND: Papanicolaou (Pap) cytology and high-risk human papillomavirus (HPV) DNA cotesting for women aged ≥30 years are recommended for the prevention of cervical cancer. The objective of the current study was to evaluate the efficacy of this cotesting for predicting the risk of high-grade cervical intraepithelial neoplasia 3 (CIN3) during a 3-year follow-up period.
METHODS: A retrospective database search identified women aged ≥30 years who had baseline HPV and Pap cytology cotesting results in 2007 or 2008 and for whom 3-year follow-up results were available. The cumulative 3-year risks of developing CIN-3 were calculated.
RESULTS: The 3-year follow-up data after baseline Pap/HPV cotesting were available for 1986 women (mean age, 53 years). Of the 1668 women who had a baseline Pap-negative (Pap-)/HPV- cotesting result, 1561 (93.6%) had a follow-up Pap cytology result that was negative for intraepithelial lesions or malignancy. Of the 1530 women who had follow-up Pap/HPV cotesting, 1504 (98.3%) had a Pap-/HPV- result. The 3-year cumulative risk of developing CIN-3 was found to be highest for women with a baseline Pap-positive (Pap+)/HPV+ cotesting result (12.5%); the risk of CIN-3 was lower in those with a Pap-/HPV+ result (1.5%; P = .0032) or a Pap-/HPV- result (0.06%; P<.0001). The 3-year cumulative risk of CIN-3 was found to be significantly greater for women with an HPV+ result (4.8%) compared with those with an HPV- result (0.06%; P<.0001).
CONCLUSIONS: Pap cytology and HPV cotesting are valuable for stratifying CIN-3 risk. Pap cytology and HPV co-screening at a 3-year screening interval appears to carry a low risk of CIN-3 for women who have a baseline Pap-/HPV- cotesting result. Cancer Cytopathol 2017;125:644-51. © 2017 American Cancer Society.

Keywords

Papanicolaou (Pap) test cancer screening tests cervical intraepithelial neoplasia (CIN) follow-up studies human papillomavirus (HPV)

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Grants

  1. P30 CA016672/NCI NIH HHS

MeSH Term

Adult
Aged
Atypical Squamous Cells of the Cervix
Databases, Factual
Early Detection of Cancer
Female
Human Papillomavirus DNA Tests
Humans
Middle Aged
Neoplasm Grading
Papanicolaou Test
Papillomavirus Infections
Retrospective Studies
Risk Assessment
Squamous Intraepithelial Lesions of the Cervix
Uterine Cervical Neoplasms
Vaginal Smears
Uterine Cervical Dysplasia
Journal Article
Article has an altmetric score of 8

Word Cloud

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