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- Title
Older women testing positive for HPV16/18 on cervical screening and risk of high‐grade cervical abnormality.
- Authors
Roberts, Jennifer Margaret; Machalek, Dorothy A.; Butler, Bethan C.; Crescini, Joanne; Garland, Suzanne M.; Farnsworth, Annabelle
- Abstract
In Australia's HPV‐based cervical screening program, we previously showed that risk of histological high‐grade abnormality at 1 year post screening decreased with age in women with oncogenic HPV. In this study, we followed 878 HPV16/18 positive women aged 55 years and over for up to 3 years post screening test, to determine the proportion with histological high‐grade abnormality (HGA, incorporating high‐grade squamous intraepithelial abnormality (HSIL), adenocarcinoma in situ (AIS), squamous cell carcinoma (SCC) and adenocarcinoma) and to correlate risk of HGA with liquid‐based cytology result and with prior screening history. HGA was detected in 7.8% at 1 year and 10.0% at 3 years, with no significant difference (P =.136), despite the number of women with follow‐up information significantly increasing from 82.9% to 91.0% (P <.0001). The proportion of HPV16/18 positive women with HGA at 3 years was highest in those with an HSIL cytology result (79.0%) and lowest in those with negative cytology (6.2%). Women with an adequate screening history had fewer HGA than such women with inadequate prior screening (6.6% vs 16.0%, P =.001) or with a history of an abnormality (6.6% vs 14.4%, P =.001). HPV16/18 infection in women over 55 years may have a different natural history from that in younger women, in whom HGA are more common after HPV16/18 detection. In HPV‐based cervical screening programs, management algorithms for screen‐detected abnormalities based on risk stratification should include factors such as age, screening history and index cytology result, so that women receive appropriate investigation and follow‐up.
- Subjects
OLDER women; SQUAMOUS cell carcinoma
- Publication
International Journal of Cancer, 2023, Vol 152, Issue 8, p1593
- ISSN
0020-7136
- Publication type
Article
- DOI
10.1002/ijc.34393