Article Text
Abstract
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.