A Study of Genotyping for Management of Human Papillomavirus-Positive, Cytology-Negative Cervical Screening Results

• DOI: 10.1128/jcm.02116-14
• Publication Date: 2014-10-23T02:07:39Z
• Authors: M. Schiffman; R. D. Burk; S. Boyle; T. Raine-Bennett; H. A. Katki; J. C. Gage; N. Wentzensen; J. R. Kornegay; C. Aldrich; T. Tam; H. Erlich; R. Apple; B. Befano; P. E. Castle
• Keywords: Papillomaviridae; Cervical screening

The effective management of women with human papillomavirus (HPV)-positive, cytology-negative results is critical to the introduction HPV testing into cervical screening. typing has been recommended for colposcopy triage, but it not clear which combinations high-risk types provide clinically useful information. This study included 18,810 Hybrid Capture 2 (HC2)-positive, and who were age ≥30 years from Kaiser Permanente Northern California. median follow-up was 475 days (interquartile range [IQR], 0 1,077 days; maximum, 2,217 days). baseline specimens 482 cases intraepithelial neoplasia grade 3 or cancer (CIN3+) 3,517 random HC2-positive noncases genotyped using PCR-based methods. Using case-control sampling fractions, 3-year cumulative risks CIN3+ calculated each individual type. risk among all HC2-positive, 4.6%. HPV16 status conferred greatest type-specific stratification; HC2-positive/HPV16-positive had a 10.6% CIN3+, while HC-2 positive/HPV16-negative much lower 2.4%. next most informative their in HPV-positive HPV33 (5.9%) HPV18 (5.9%). With regard etiologic fraction, 20 71 adenocarcinoma situ (AIS) cohort positive HPV18. genotyping provides stratification guiding clinical management; HPV16-positive clearly exceeds U.S. consensus threshold immediate referral. particular interest because its association difficult-to-detect glandular lesions. There less value distinguishing other types.