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.
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。