Short-term repeat HPV testing for triaging HPV-positive women in cervical cancer screening

BACKGROUND: Persistent HPV infection causes cervical cancer, but most infections are transient. Triage methods identify high-risk women needing further evaluation or treatment. We assessed short-term repeat HPV testing as an alternative triage option. METHODS: In ESTAMPA, women aged 30-64 years were...

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Autores principales: Armando Baena, Marı́a Alejandra Picconi, Laura Mendoza, Annabelle Ferrera, David Mesher, Johana Lineros, Marisol Brizuela, Pamela Mongelós, Yessy Cabrera, Marı́a Dolores Fellner, Osmalia Zambrana, Laura García, Pilar Hernández, María Liz Bobadilla, María Antonia Ramón, Gino Venegas Rodríguez, Verónica Villagra, Aurelio Cruz-Valdéz, Guillermo Rodríguez‐Domínguez, Carolina Terán, Alejandro Calderón, Carolina Wiesner, Rolando Herrero, Maribel Almonte, on behalf of the ESTAMPA study group, Yenny Bellido‐Fuentes, Andrea Verónica Beracochea, María Celeste Colucci, Rita Mariel Correa, Jacqueline Figueroa, Bettsy Flores, Diana Gimenez, María de la Luz Hernández, Elena Kasamatsu, Victoria Murillo, Marina Ortega, Natalia Pérez, Rolando Pinastel Monet, Arianis Tatiana Ramírez, Maria Isabel Rodríguez, Mercedes Rodríguez de la Peña, Yuli Salgado, Ana Soilán, Charles Quesada
Formato: Artículo
Lenguaje:inglés
Publicado: 2025
Materias:
Medicine
Cervical cancer screening
Cervical cancer
Gynecology
Oncology
Cervical screening
Medical screening
Internal medicine
Human papillomavirus
Papillomaviridae
Cancer screening
MEDLINE
Colposcopy
Uterine cervix
Predictive value of tests
Retrospective cohort study
Epidemiology
Obstetrics
Cancer
Cervix
Risk assessment
Premalignant lesion
Screening test
Sexually transmitted disease
Cervical intraepithelial neoplasia
Young adult
Cervical carcinoma
Viral disease
Adult
Uterine Cervical Dysplasia diagnosis
Uterine Cervical Dysplasia virology
Uterine Cervical Neoplasms diagnosis
Uterine Cervical Neoplasms pathology
Uterine Cervical Neoplasms virology
Female
Genotype
Humans
Middle Aged
Triage methods
Papillomaviridae genetics
Papillomaviridae isolation & purification
Papillomavirus Infections diagnosis
Papillomavirus Infections virology
Human papillomavirus 18 genetics
Human papillomavirus 18 isolation & purification
Human papillomavirus 16 genetics
Human papillomavirus 16 isolation & purification
Early Detection of Cancer methods
Health Sciences Medicine Epidemiology Cervical Cancer and HPV Research
Health Sciences Medicine Otorhinolaryngology Head and Neck Cancer Studies
Health Sciences Medicine Public Health, Environmental and Occupational Health Women's cancer prevention and management
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Sumario:BACKGROUND: Persistent HPV infection causes cervical cancer, but most infections are transient. Triage methods identify high-risk women needing further evaluation or treatment. We assessed short-term repeat HPV testing as an alternative triage option. METHODS: In ESTAMPA, women aged 30-64 years were screened with HPV testing (HC2 or Cobas) and cytology. Screen positives were referred to colposcopy approximately two months after screening, where cervical samples were collected again for repeat HPV testing. We evaluated the performance of repeat HPV for CIN3+ among HPV-positive women and explored its combination with limited HPV genotyping (HPV16/18). RESULTS: Among 5390 HPV-positive women (including 629 CIN3 cases and 53 cancers), 61% retested positive at ~2 months (median: 1.8, interquartile range: 1.2-2.8). Repeat HPV sensitivity for CIN3+ was 81.5% (95% CI 77.2-85.2) for HC2 and 87.7% (83.7-90.8) for Cobas. Specificity was <50% with referral rates of 57.4% (55.7-59.0) and 68.2% (66.1-70.2) for HC2 and Cobas. HPV16/18 genotyping followed by repeat HPV among non-HPV16/18-positive women did not greatly improve performance. However, HPV16/18 positivity doubled the risk of CIN3+, supporting its combination with repeat HPV when available. CONCLUSIONS: Short-term repeat HPV testing could be a practical option for triaging HPV-positive women, either alone or in combination with limited HPV genotyping. TRIAL REGISTRATION: ClinicalTrials.gov, NCT01881659.

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