PDF(Pubmed)
Abstract：
UNASSIGNED: The growing use of primary human papillomavirus (HPV) cervical cancer screening requires determining appropriate screening intervals to avoid overtreatment of transient disease. This study examined the long-term risk of cervical precancer after HPV screening to inform screening interval recommendations.
UNASSIGNED: This longitudinal cohort study (British Columbia, Canada, 2008 to 2022) recruited women and individuals with a cervix who received 1 to 2 negative HPV screens (HPV1 cohort, N = 5,546; HPV2 cohort, N = 6,624) during a randomized trial and women and individuals with a cervix with 1 to 2 normal cytology results (BCS1 cohort, N = 782,297; BCS2 cohort, N = 673,778) extracted from the provincial screening registry. All participants were followed through the registry for 14 years. Long-term risk of cervical precancer or worse [cervical intraepithelial neoplasia grade 2 or worse (CIN2+)] was compared between HPV and cytology cohorts.
UNASSIGNED: Cumulative risks of CIN2+ were 3.2/1,000 [95% confidence interval (CI), 1.6-4.7] in HPV1 and 2.7/1,000 (95% CI, 1.2-4.2) in HPV2 after 8 years. This was comparable with the risk in the cytology cohorts after 3 years [BCS1: 3.3/1,000 (95% CI, 3.1-3.4); BCS2: 2.5/1,000 (95% CI, 2.4-2.6)]. The cumulative risk of CIN2+ after 10 years was low in the HPV cohorts [HPV1: 4.7/1,000 (95% CI, 2.6-6.7); HPV2: 3.9 (95% CI, 1.1-6.6)].
UNASSIGNED: Risk of CIN2+ 8 years after a negative screen in the HPV cohorts was comparable with risk after 3 years in the cytology cohorts (the benchmark for acceptable risk).
UNASSIGNED: These findings suggest that primary HPV screening intervals could be extended beyond the current 5-year recommendation, potentially reducing barriers to screening.
UNASSIGNED: This longitudinal cohort study (British Columbia, Canada, 2008 to 2022) recruited women and individuals with a cervix who received 1 to 2 negative HPV screens (HPV1 cohort, N = 5,546; HPV2 cohort, N = 6,624) during a randomized trial and women and individuals with a cervix with 1 to 2 normal cytology results (BCS1 cohort, N = 782,297; BCS2 cohort, N = 673,778) extracted from the provincial screening registry. All participants were followed through the registry for 14 years. Long-term risk of cervical precancer or worse [cervical intraepithelial neoplasia grade 2 or worse (CIN2+)] was compared between HPV and cytology cohorts.
UNASSIGNED: Cumulative risks of CIN2+ were 3.2/1,000 [95% confidence interval (CI), 1.6-4.7] in HPV1 and 2.7/1,000 (95% CI, 1.2-4.2) in HPV2 after 8 years. This was comparable with the risk in the cytology cohorts after 3 years [BCS1: 3.3/1,000 (95% CI, 3.1-3.4); BCS2: 2.5/1,000 (95% CI, 2.4-2.6)]. The cumulative risk of CIN2+ after 10 years was low in the HPV cohorts [HPV1: 4.7/1,000 (95% CI, 2.6-6.7); HPV2: 3.9 (95% CI, 1.1-6.6)].
UNASSIGNED: Risk of CIN2+ 8 years after a negative screen in the HPV cohorts was comparable with risk after 3 years in the cytology cohorts (the benchmark for acceptable risk).
UNASSIGNED: These findings suggest that primary HPV screening intervals could be extended beyond the current 5-year recommendation, potentially reducing barriers to screening.
摘要：
背景：越来越多地使用原发性HPV宫颈癌筛查需要确定适当的筛查间隔，以避免对短暂疾病的过度治疗。这项研究检查了HPV筛查后宫颈癌前病变的长期风险，以告知筛查间隔建议。
方法：这项纵向队列研究(不列颠哥伦比亚省，加拿大,2008-2022年）招募了接受1-2阴性HPV筛查的宫颈（WIC）妇女和个人（HPV1队列，N=5,546,HPV2队列,N=6,624）在一项随机试验和WIC中有1-2个正常细胞学结果（BCS1队列，N=782,297，BCS2队列，N=673,778)从省筛查登记处提取。所有参与者都被跟踪了14年的注册。在HPV和细胞学队列之间比较了宫颈癌前病变或病变（CIN2+）的长期风险。
结果：八年后，HPV1和HPV2的CIN2+累积风险分别为3.2/1000（95％CI：1.6至4.7）和2.7/1000（CI：1.2至4.2）。这与3年后的细胞学队列中的风险相当（BCS1：3.3/1000，[CI：3.1至3.4]；BCS2：2.5，[CI：2.4至2.6]）。HPV队列中10年后CIN2+的累积风险较低（HPV1：4.7/1000，[CI：2.6至6.7]；HPV2：3.9，[CI：1.1至6.6]）。
结论：HPV队列阴性筛查8年后CIN2+的风险与细胞学队列3年后的风险相当（可接受风险的基准）。
结论：这些研究结果表明，初次HPV筛查间隔可以延长到目前的5年建议之外，可能会减少筛查的障碍。
方法：这项纵向队列研究(不列颠哥伦比亚省，加拿大,2008-2022年）招募了接受1-2阴性HPV筛查的宫颈（WIC）妇女和个人（HPV1队列，N=5,546,HPV2队列,N=6,624）在一项随机试验和WIC中有1-2个正常细胞学结果（BCS1队列，N=782,297，BCS2队列，N=673,778)从省筛查登记处提取。所有参与者都被跟踪了14年的注册。在HPV和细胞学队列之间比较了宫颈癌前病变或病变（CIN2+）的长期风险。
结果：八年后，HPV1和HPV2的CIN2+累积风险分别为3.2/1000（95％CI：1.6至4.7）和2.7/1000（CI：1.2至4.2）。这与3年后的细胞学队列中的风险相当（BCS1：3.3/1000，[CI：3.1至3.4]；BCS2：2.5，[CI：2.4至2.6]）。HPV队列中10年后CIN2+的累积风险较低（HPV1：4.7/1000，[CI：2.6至6.7]；HPV2：3.9，[CI：1.1至6.6]）。
结论：HPV队列阴性筛查8年后CIN2+的风险与细胞学队列3年后的风险相当（可接受风险的基准）。
结论：这些研究结果表明，初次HPV筛查间隔可以延长到目前的5年建议之外，可能会减少筛查的障碍。
