Introduction
Selective utilization of human papillomavirus (HPV) genotyping in cervical cancer
screening can accelerate clinical management, leading to earlier identification and
treatment of precancerous lesions and cancer. Specifically, immediate colposcopy (instead
of 1-year return) is recommended in persons with normal cytology and HPV genotypes
16 and/or 18, and expedited treatment (instead of colposcopy) is recommended in persons
with high-grade squamous intraepithelial lesion (HSIL) cytology and HPV genotype 16.
The effects of implementing HPV testing and genotyping into a screening program are
largely unknown.
Methods
Average-risk persons aged 30–65 years screened for cervical cancer in the National
Breast and Cervical Cancer Early Detection Program from 2019 to 2020 were included
(N=104,991). Percentage HPV genotyping test positivity was estimated within cytology
result categories. Analyses were performed in 2022.
Results
The most common abnormality was positive high-risk HPV testing with normal cytology,
representing 40.1% (7,155/17,832) of all abnormal test result categories; HSIL cytology
represented 3.0% (530/17,832) of all abnormal test result categories. In high-risk
HPV‒positive persons with normal or high-grade cytology, HPV genotyping could accelerate
management (immediate colposcopy and expedited treatment) in 5.4% of all persons with
abnormal screening test results; if HPV genotyping had been performed in all high-risk
HPV‒positive persons with normal or HSIL cytology, approximately 13.1% could have
accelerated management.
Conclusions
HPV genotyping in human papillomavirus‒positive persons with normal or HSIL cytology
could accelerate management in a sizable percentage of persons with abnormal test
results and may be particularly useful in populations with challenges adhering to
longitudinal follow-up.
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REFERENCES
U.S. Cancer Statistics Working Group. U.S. Cancer Statistics Data Visualizations Tool, based on 2021 submission data (1999-2019): U.S. Department of Health and Human Services, Centers for Disease Control and Prevention and National Cancer Institute. https://www.cdc.gov/cancer/dataviz. Published November 2022. Accessed December 2, 2022.
- A population study of screening history and diagnostic outcomes of women with invasive cervical cancer.Cancer Med. 2021; 10: 4127-4137https://doi.org/10.1002/cam4.3951
- Risk of cervical precancer and cancer among uninsured and underserved women from 2009 to 2017.Am J Obstet Gynecol. 2021; 224: 366.e1-366.e32https://doi.org/10.1016/j.ajog.2020.10.001
- Screening for cervical cancer: U.S. Preventive Services Task Force recommendation statement.JAMA. 2018; 320: 674-686https://doi.org/10.1001/jama.2018.10897
- A study of partial human papillomavirus genotyping in support of the 2019 ASCCP risk-based management consensus guidelines.J Low Genit Tract Dis. 2020; 24: 144-147https://doi.org/10.1097/LGT.0000000000000530
- 2019 ASCCP risk-based management consensus guidelines for abnormal cervical cancer screening tests and cancer precursors.J Low Genit Tract Dis. 2020; 24: 102-131https://doi.org/10.1097/LGT.0000000000000525
- Prevalence of high-risk human papilloma virus genotypes and associated risk of cervical precancerous lesions in a large U.S. screening population: data from the ATHENA trial.Gynecol Oncol. 2015; 137: 47-54https://doi.org/10.1016/j.ygyno.2015.01.551
World Health Organization. Global strategy to accelerate the elimination of cervical cancer as a public health problem. https://www.who.int/publications/i/item/9789240014107 Updated November 17, 2020. Accessed December 2, 2022.
- Estimated quality of life and economic outcomes associated with 12 cervical cancer screening strategies: a cost-effectiveness analysis.JAMA Intern Med. 2019; 179: 867-878https://doi.org/10.1001/jamainternmed.2019.0299
- Adverse psychological outcomes following colposcopy and related procedures: a systematic review.BJOG. 2016; 123: 24-38https://doi.org/10.1111/1471-0528.13462
Article info
Publication history
Published online: February 15, 2023
Identification
Copyright
© 2022 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
