Objective:We assessed the longitudinal risk of developing cervical intraepithelial neoplasia(CINs)with self-sampling human papillomavirus(HPV)tests,based on polymerase chain reaction(PCR)and signal amplification(care ...Objective:We assessed the longitudinal risk of developing cervical intraepithelial neoplasia(CINs)with self-sampling human papillomavirus(HPV)tests,based on polymerase chain reaction(PCR)and signal amplification(care HPV),to explore the appropriate intervals for cervical cancer screening.Methods:A prospective study was conducted in China during 2017-2020.Participants were invited for PCR and care HPV tests with self-samples at baseline.Women positive in either HPV test underwent colposcopy and biopsy if necessary.Women with baseline CIN grade one(CIN1)or less were followed up over 3 years.The absolute risk was assessed by the immediate risk(IR)and cumulative risk(CR),and the relative risk was assessed by the hazard ratio(HR)with a 95%confidence interval(CI).Results:A total of 8,126 women were included in the final analysis.Women positive for the PCR HPV test had comparable IRs of CIN2+and CIN3+to those positive on the care HPV test.With triage by HPV genotyping,women with HPV 16/18 infection had the highest IRs of CIN2+(21.15%)and CIN3+(9.67%).For CR,women negative for PCR HPV test had a lower risk of CIN2+than that reported in women negative on care HPV test(0.57%versus 0.98%,HR=0.58,95%CI:0.38,0.87),but no significant difference was found in the CRs of CIN3+between them(0.25%versus 0.39%,HR=0.64,95%CI:0.34,1.20).Among women with CIN1 or less at baseline,women who were persistent or recurrent positive on care HPV or PCR HPV test had a higher risk of developing CIN3+(11.36%-14.59%),compared with women remained HPV negative from baseline throughout follow-up(≤0.28%).Conclusions:Routine screening with 3-year intervals is acceptable for self-sampling HPV tests based on PCR or care HPV test.Women positive on HPV16/18 triaging at baseline or with CIN1 or less at baseline while being per-sistent or recurrent positive on care HPV or PCR HPV test during 3-year follow-up require immediate colposcopy or treatment.展开更多
基金supported by the China Med-ical Board(grant number:16-255)the National Key R&D Program of China(grant number:2018YFC1315504)the National Natural Sci-ence Foundation of China(grant number:81761128006).
文摘Objective:We assessed the longitudinal risk of developing cervical intraepithelial neoplasia(CINs)with self-sampling human papillomavirus(HPV)tests,based on polymerase chain reaction(PCR)and signal amplification(care HPV),to explore the appropriate intervals for cervical cancer screening.Methods:A prospective study was conducted in China during 2017-2020.Participants were invited for PCR and care HPV tests with self-samples at baseline.Women positive in either HPV test underwent colposcopy and biopsy if necessary.Women with baseline CIN grade one(CIN1)or less were followed up over 3 years.The absolute risk was assessed by the immediate risk(IR)and cumulative risk(CR),and the relative risk was assessed by the hazard ratio(HR)with a 95%confidence interval(CI).Results:A total of 8,126 women were included in the final analysis.Women positive for the PCR HPV test had comparable IRs of CIN2+and CIN3+to those positive on the care HPV test.With triage by HPV genotyping,women with HPV 16/18 infection had the highest IRs of CIN2+(21.15%)and CIN3+(9.67%).For CR,women negative for PCR HPV test had a lower risk of CIN2+than that reported in women negative on care HPV test(0.57%versus 0.98%,HR=0.58,95%CI:0.38,0.87),but no significant difference was found in the CRs of CIN3+between them(0.25%versus 0.39%,HR=0.64,95%CI:0.34,1.20).Among women with CIN1 or less at baseline,women who were persistent or recurrent positive on care HPV or PCR HPV test had a higher risk of developing CIN3+(11.36%-14.59%),compared with women remained HPV negative from baseline throughout follow-up(≤0.28%).Conclusions:Routine screening with 3-year intervals is acceptable for self-sampling HPV tests based on PCR or care HPV test.Women positive on HPV16/18 triaging at baseline or with CIN1 or less at baseline while being per-sistent or recurrent positive on care HPV or PCR HPV test during 3-year follow-up require immediate colposcopy or treatment.
