Level 2: Mid-level evidence
A multinational cohort study evaluated 24,295 women who had cervical cytology and HPV screening at baseline and one or more cervical cytology or histopathology exams within the five- to six-year follow-up period (BMJ. 2008;337:a1754). Follow-up was completed by 20%-31% of women, which may weaken the predictive value of negative HPV DNA results. Cervical intraepithelial neoplasia (CIN) grade 3 or cancer (CIN3+) developed in 1.6% of patients. Cumulative incidence of CIN3+ in women with negative cytology results was 0.51% at three years and 0.97% at six years; cumulative incidence of CIN3+ in women negative for HPV was 0.12% at three years and 0.27% at six years. The rate of CIN3+ at six years was highest in women positive for HPV at baseline: 0.28% in women with negative cytology and negative HPV, 2.7% in women with abnormal cytology and negative HPV, 10% in women with negative cytology but positive for HPV, and 34% in women with abnormal cytology and positive for HPV.
Publish Date
Negative HPV DNA testing may predict very low risk of CIN grade 3 or cancer
