The study included 43,339 women, between the ages of 29 and 61 years, with a negative human papillomavirus and/or negative cytology test. These women were randomly assigned to HPV and cytology co-testing or cytology testing only. One of the main outcome measures was the cumulative incidence of cervical cancer and cervical intraepithelial neoplasia grade 3 or worse (CIN3+).
Here are five findings:
1. The cumulative incidence of cervical cancer and CIN3+ among HPV-negative women in the co-testing group after three rounds of screening was similar to the cumulative among women with negative cytology in the control group after two rounds.
2. Cervical cancer and CIN3+ risk ratios were 0.97 and 0.82, respectively.
3. CIN3+ incidence was 72.2 percent lower among HPV-negative women aged 40 years and older as compared to younger women.
4. The findings did not demonstrate any significant association between cervical cancer incidence and age.
5. HPV-positive women with subsequent negative cytology, HPV16/18 genotyping, and/or repeat cytology have at least a five-fold higher risk of CIN3+ than HPV-negative women. This indicates that “HPV-based programs with long intervals (greater than five years) should be implemented with risk stratification,” according to the study.
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