Cervical Cancer, CIN3+ Screening After 5 Years in HPV-Negative Women

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Papanicolaou stained biopsy of vaginal tissue indicative of adenocarcinoma. <i>Photo credit: CDC/ A. Elizabeth Plott, C.T.(ASCP)</i>
Papanicolaou stained biopsy of vaginal tissue indicative of adenocarcinoma. Photo credit: CDC/ A. Elizabeth Plott, C.T.(ASCP)

HealthDay News—Human papillomavirus (HPV)-negative women have low long-term incidence of cervical cancer and cervical intraepithelial neoplasia (CIN) grade 3 or worse (CIN3+), which supports an extension of the cervical screening interval beyond 5 years for certain women, according to a study published online in The BMJ.

Maaike G. Dijkstra, MD, from the VU University Medical Center in Amsterdam, and colleagues conducted a 14-year follow-up of 43,339 women aged 29 to 61 years with a negative HPV and/or negative cytology test. Participants were randomly assigned to HPV and cytology co-testing (intervention) or cytology-only testing (control).

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The researchers found that HPV-negative women in the intervention group had cumulative incidence of cervical cancer and CIN3+ of 0.09% and 0.56% percent, respectively, after 3 rounds of screening, similar to 0.09 and 0.69% percent, respectively, for women with negative cytology in the control group after 2 rounds of screening. The risk ratios for cervical cancer and CIN3+ were 0.97 (95% confidence interval [CI], 0.41-2.31) and 0.82 (95% CI, 0.62-1.09). Compared with younger women, HPV-negative women aged at least 40 years had lower CIN3+ incidence (72.2%; 95% CI, 61.6%-79.9%). There was no significant correlation between incidence of cervical cancer and age.

"Long term incidences of cervical cancer and CIN3+ were low among HPV-negative women in this study cohort, and supports an extension of the cervical screening interval beyond 5 years for women aged 40 years and older," the authors write.

Several authors disclosed financial ties to the biopharmaceutical industry.

Reference

Dijkstra MG, van Zummeren M, va Kemenade FJ, et al. Safety of extending screening intervals beyond 5 years in cervical screening programmes with testing for high risk human papillomavirus: 14-year follow-up of population based randomized cohort in the Netherlands. BMJ. 2016;355:i4924. doi: 10.1136/bmj.i4924 

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