Available online 28 May 2022, 200240

Little is known about the long-term association between high-risk human papillomavirus (hrHPV) test results in women participating in a hrHPV-based cervical cancer screening program. To address this question, we collected data of 2217 women who participated in the POBASCAM hrHPV-based screening trial (enrolment 1999/2002) and also attended the Dutch hrHPV-based screening program between January 2017 and March 2018. Among 143 women who tested hrHPV-positive in 1999/2002, 45 (31.5%) had ≥ CIN2 or hysterectomy before 2017 and 17 (11.9%) tested hrHPV-positive at the 2017/2018 screen. In comparison, among 2074 women who tested hrHPV-negative in 1999/2002, 10 (0.5%) had ≥ CIN2 or hysterectomy before 2017 and 119 (5.7%) tested hrHPV-positive at the 2017/2018 screen. It follows that in the group of women who were not treated for ≥ CIN2 or had a hysterectomy in between the two screens 15 years apart (N = 2162), women who were hrHPV-positive in 1999/2002 had a higher risk of being hrHPV-positive in 2017/2018 than those who were hrHPV-negative in 1999/2002 (OR 3.4, 95% CI 1.8–6.1). A similar association was found at the genotype level for genotype-concordant results (5.1, 1.0–11.3) and for genotype non-concordant results (3.7, 1.6–6.7). Women who were hrHPV-positive in 2017/2018 had a higher risk of CIN3 after a hrHPV-positive result in 1999/2002 than after a hrHPV-negative result (5.8, 1.0–27.8). In conclusion, a positive hrHPV result in screening gives a long-term increased risk of a hrHPV-positive result, also for different genotypes, and a long-term increased risk of CIN3. This supports the concept of risk-stratification in hrHPV-based cervical cancer screening where previous hrHPV results are included in screening recommendations.

Human papillomavirus (HPV)

Genotype

Cervical intraepithelial neoplasia (CIN)

Cervical screening

Screening interval

atypical squamous cells of undetermined significance or worse

cervical intraepithelial neoplasia grade 2 or worse

cervical intraepithelial neoplasia grade 3 or worse

high-risk human papillomavirus

nationwide network and registry of histo- and cytopathology in the Netherlands, Dutch for “Pathologisch-Anatomisch Landelijk Geautomatiseerd Archief”

Population-based Screening Study Amsterdam

© 2022 The Authors. Published by Elsevier B.V.