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350 The low risk of CIN2+ in triage negative hpv-positive women 5 years after primary screening
  1. G Stanczuk1,
  2. K Cuschieri2 and
  3. T Palmer3
  1. 1Western Isles Hospital- NHS Scotland-UK, Obstetrics and Gynaecology, Stornoway, UK
  2. 2Scottish HPV Reference Laboratory-, Royal Infirmary of Edinburgh, Edinburgh, UK
  3. 3Raigmore Hospital, Department of Pathology, Inverness, UK


Objectives The optimal triage of screen-positive women is one of the most important considerations in the HPV cervical screening. Performing liquid based cytology (LBC) on HPV-positive (HPV+) women and/or limited genotyping has been recommended as a triage strategy. Additionally p16/ki-67 dual-stained cytology is a credible triage approach. We previously reported an evaluation of triage strategies in a cross sectional study. The aim of this study was to evaluate the cumulative incidence rate (CIR) of CIN2+ within 5 years of primary triage strategies of HPV+ women.

Methods The study population comprised of 385 HPV+ women, who all had HPV 16/18 typing, LBC and p16/ki-67 dual-stained cytology at the first screening round. We used two rounds screening results to describe cumulative incidence rate (CIR) of CIN2+ within 5 years of primary HPV+ testing stratified by the various triage strategies with proportions reflected within 95% confidence intervals.

Results The length of follow-up was up to 5.5 years. The HPV+ women with an LBC negative triage had 5-year CIR of CIN2+of 9.4%(6.5–13.3%) compared with 7.2% (4.6–11.1%) in women who were p16/ki-67 dual-stained cytology negative and 10.6% (7.5–15%) in women who were HVP 16/18 negative. Regarding combination approaches, HPV 16/18 negative/LBC negative women had 5-year CIR of CIN2+of 3.9% (2.0–7.6%). Women who were ‘‘‘‘‘triple’’’’’ triage negative had the lowest CIR of CIN2+ of 2.4% (0.9–6.0%).

Conclusions Full analysis will be presented however; our initial data indicate that multistep triage options may offer the greatest longitudinal protection for concurrent and subsequent disease compare to individual approaches.

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