In:
Cancer Cytopathology, Wiley, Vol. 122, No. 11 ( 2014-11), p. 842-850
Abstract:
Different US practice guidelines have conflicting recommendations for when women should return after a screening result of human papillomavirus (HPV)‐negative with an equivocal Papanicolaou (Pap) result of atypical squamous cells of undetermined significance (ASC‐US) (ie, return in either 3 or 5 years). One way to determine management is to compare the risk of precancer/cancer after an HPV‐negative/ASC‐US result with the risks after other negative screening results. For example, if the risk after an HPV‐negative/ASC‐US result was similar to the risk after a negative Pap test, a 3‐year return would be preferred because guidelines agree that women with negative Pap test results should return in 3 years. Alternatively, if the risk after an HPV‐negative/ASC‐US result is similar to that after a cotest‐negative result (HPV negative/Pap test negative), a 5‐year return would be preferred because guidelines agree that women testing cotest negative should return in 5 years. METHODS The authors compared risks of cervical intraepithelial neoplasia of grade 3 or higher (CIN3+) and cervical cancer among women aged 30 years to 64 years at Kaiser Permanente Northern California with the following test results from 2003 through 2012: 17,191 women testing HPV negative/ASC‐US; 980,268 women testing Pap test negative (regardless of HPV result); and 892,882 women testing cotest negative. RESULTS The 5‐year CIN3+ and cancer risks after an HPV‐negative/ASC‐US result were closer to the risks after a negative Pap test result (CIN3+: 0.48% vs 0.31% [ P = .0019]; and cancer: 0.043% vs 0.031% [ P = .4]) than after a negative cotest (CIN3+: 0.48% vs 0.11% [ P 〈 .0001]; and cancer: 0.043% vs 0.014% [ P = .016]). CONCLUSIONS Women testing HPV negative/ASC‐US were found to have precancer/cancer risks that were more closely aligned with women with negative Pap test results, suggesting that women testing HPV negative/ASC‐US should be managed similarly to women testing negative on Pap tests with a 3‐year return for screening. Cancer (Cancer Cytopathol) 2014;122:842–850 . © 2014 American Cancer Society .
Type of Medium:
Online Resource
ISSN:
1934-662X
,
1934-6638
DOI:
10.1002/cncy.v122.11
Language:
English
Publisher:
Wiley
Publication Date:
2014
detail.hit.zdb_id:
2599218-1
detail.hit.zdb_id:
2594979-2
detail.hit.zdb_id:
1429-1
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