Reassurance against future risk of precancer and cancer conferred by a negative human papillomavirus test

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

Research output: Contribution to journalArticle

116 Citations (Scopus)

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 1 011 092 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.

Original languageEnglish (US)
Article numberdju153
JournalJournal of the National Cancer Institute
Volume106
Issue number8
DOIs
StatePublished - Aug 1 2014
Externally publishedYes

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Neoplasms
Papanicolaou Test
Cervical Intraepithelial Neoplasia
Early Detection of Cancer
Uterine Cervical Neoplasms
Logistic Models
Survival

ASJC Scopus subject areas

  • Medicine(all)
  • Oncology
  • Cancer Research

Cite this

Reassurance against future risk of precancer and cancer conferred by a negative human papillomavirus test. / Gage, Julia C.; Schiffman, Mark; Katki, Hormuzd A.; Castle, Philip E.; Fetterman, Barbara; Wentzensen, Nicolas; Poitras, Nancy E.; Lorey, Thomas; Cheung, Li C.; Kinney, Walter K.

In: Journal of the National Cancer Institute, Vol. 106, No. 8, dju153, 01.08.2014.

Research output: Contribution to journalArticle

Gage, JC, Schiffman, M, Katki, HA, Castle, PE, Fetterman, B, Wentzensen, N, Poitras, NE, Lorey, T, Cheung, LC & Kinney, WK 2014, 'Reassurance against future risk of precancer and cancer conferred by a negative human papillomavirus test', Journal of the National Cancer Institute, vol. 106, no. 8, dju153. https://doi.org/10.1093/jnci/dju153
Gage, Julia C. ; Schiffman, Mark ; Katki, Hormuzd A. ; Castle, Philip E. ; Fetterman, Barbara ; Wentzensen, Nicolas ; Poitras, Nancy E. ; Lorey, Thomas ; Cheung, Li C. ; Kinney, Walter K. / Reassurance against future risk of precancer and cancer conferred by a negative human papillomavirus test. In: Journal of the National Cancer Institute. 2014 ; Vol. 106, No. 8.
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