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Human papillomavirus type-specific 18-month risk of high-grade cervical intraepithelial neoplasia in women with a normal or borderline/mildly dyskaryotic smear.
Cancer Epidemiol Biomarkers Prev. 2006 Jul; 15(7):1268-73.CE

Abstract

INTRODUCTION

High-risk human papillomavirus (hrHPV) DNA testing is an increasingly used instrument in cervical cancer prevention along cervical cytology. The inclusion of hrHPV testing in cervical screening requires efficient management as many hrHPV infections are transient. We investigated the potential value of hrHPV genotyping in normal and borderline/mildly dyskaryotic (BMD) smears.

MATERIALS AND METHODS

From a screening population of 44,102 women in the Netherlands, we included hrHPV-positive women with a normal or BMD smear. We assessed the type-specific 18-month risk of high-grade cervical intraepithelial neoplasia (CIN).

RESULTS

In hrHPV-positive women, 18-month risk of CIN grade 3 or invasive cancer (> or =CIN3) was 6% [95% confidence interval (95% CI), 4-9] after normal cytology and 20% (95% CI, 16-25) after BMD. If positive for HPV16, > or =CIN3 risks were 14% (95% CI, 9-21) and 37% (95% CI, 28-48), respectively. In the subset of hrHPV-positive women without HPV16, HPV18 was associated with an increased risk of high-grade CIN after normal cytology and HPV31 and HPV33 were associated with an increased risk, particularly after BMD. HPV16 and HPV18 were also associated with an increased risk of high-grade CIN in women with an hrHPV-positive normal baseline smear and a repeat normal smear at 6 months.

DISCUSSION

HrHPV-positive women without type 16, 18, 31, or 33 had a relatively low risk of high-grade CIN. Among women with baseline normal cytology and among women with a baseline and repeat normal smear, HPV16/18-positive women showed an increased risk of high-grade CIN. This warrants more aggressive management of HPV16/18-positive women compared with other hrHPV-positive women.

Authors+Show Affiliations

Department of Clinical Epidemiology and Biostatistics, Vrije University Medical Center, Amsterdam, the Netherlands.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16835322

Citation

Berkhof, Johannes, et al. "Human Papillomavirus Type-specific 18-month Risk of High-grade Cervical Intraepithelial Neoplasia in Women With a Normal or Borderline/mildly Dyskaryotic Smear." Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored By the American Society of Preventive Oncology, vol. 15, no. 7, 2006, pp. 1268-73.
Berkhof J, Bulkmans NW, Bleeker MC, et al. Human papillomavirus type-specific 18-month risk of high-grade cervical intraepithelial neoplasia in women with a normal or borderline/mildly dyskaryotic smear. Cancer Epidemiol Biomarkers Prev. 2006;15(7):1268-73.
Berkhof, J., Bulkmans, N. W., Bleeker, M. C., Bulk, S., Snijders, P. J., Voorhorst, F. J., & Meijer, C. J. (2006). Human papillomavirus type-specific 18-month risk of high-grade cervical intraepithelial neoplasia in women with a normal or borderline/mildly dyskaryotic smear. Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored By the American Society of Preventive Oncology, 15(7), 1268-73.
Berkhof J, et al. Human Papillomavirus Type-specific 18-month Risk of High-grade Cervical Intraepithelial Neoplasia in Women With a Normal or Borderline/mildly Dyskaryotic Smear. Cancer Epidemiol Biomarkers Prev. 2006;15(7):1268-73. PubMed PMID: 16835322.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Human papillomavirus type-specific 18-month risk of high-grade cervical intraepithelial neoplasia in women with a normal or borderline/mildly dyskaryotic smear. AU - Berkhof,Johannes, AU - Bulkmans,Nicole W J, AU - Bleeker,Maaike C G, AU - Bulk,Saskia, AU - Snijders,Peter J F, AU - Voorhorst,Feja J, AU - Meijer,Chris J L M, PY - 2006/7/13/pubmed PY - 2006/11/15/medline PY - 2006/7/13/entrez SP - 1268 EP - 73 JF - Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology JO - Cancer Epidemiol. Biomarkers Prev. VL - 15 IS - 7 N2 - INTRODUCTION: High-risk human papillomavirus (hrHPV) DNA testing is an increasingly used instrument in cervical cancer prevention along cervical cytology. The inclusion of hrHPV testing in cervical screening requires efficient management as many hrHPV infections are transient. We investigated the potential value of hrHPV genotyping in normal and borderline/mildly dyskaryotic (BMD) smears. MATERIALS AND METHODS: From a screening population of 44,102 women in the Netherlands, we included hrHPV-positive women with a normal or BMD smear. We assessed the type-specific 18-month risk of high-grade cervical intraepithelial neoplasia (CIN). RESULTS: In hrHPV-positive women, 18-month risk of CIN grade 3 or invasive cancer (> or =CIN3) was 6% [95% confidence interval (95% CI), 4-9] after normal cytology and 20% (95% CI, 16-25) after BMD. If positive for HPV16, > or =CIN3 risks were 14% (95% CI, 9-21) and 37% (95% CI, 28-48), respectively. In the subset of hrHPV-positive women without HPV16, HPV18 was associated with an increased risk of high-grade CIN after normal cytology and HPV31 and HPV33 were associated with an increased risk, particularly after BMD. HPV16 and HPV18 were also associated with an increased risk of high-grade CIN in women with an hrHPV-positive normal baseline smear and a repeat normal smear at 6 months. DISCUSSION: HrHPV-positive women without type 16, 18, 31, or 33 had a relatively low risk of high-grade CIN. Among women with baseline normal cytology and among women with a baseline and repeat normal smear, HPV16/18-positive women showed an increased risk of high-grade CIN. This warrants more aggressive management of HPV16/18-positive women compared with other hrHPV-positive women. SN - 1055-9965 UR - https://www.unboundmedicine.com/medline/citation/16835322/Human_papillomavirus_type_specific_18_month_risk_of_high_grade_cervical_intraepithelial_neoplasia_in_women_with_a_normal_or_borderline/mildly_dyskaryotic_smear_ L2 - http://cebp.aacrjournals.org/cgi/pmidlookup?view=long&pmid=16835322 DB - PRIME DP - Unbound Medicine ER -