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Title: Reassurance against future risk of precancer and cancer conferred by a negative human papillomavirus test.
Authors: Gage JC,  Schiffman M,  Katki HA,  Castle PE,  Fetterman B,  Wentzensen N,  Poitras NE,  Lorey T,  Cheung LC,  Kinney WK
Journal: J Natl Cancer Inst
Date: 2014 Aug
Branches: BB, CGB, HREB
PubMed ID: 25038467
PMC ID: PMC4111283
Abstract: 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.