The Elevated 10-Year Risk of Cervical Precancer and Cancer in Women With Human Papillomavirus (HPV) Type 16 or 18 and the Possible Utility of Type-Specific HPV Testing in Clinical Practice

摘要: Background: Human papillomavirus (HPV) types 16 and 18 cause 60% – 70% of cervical cancer worldwide, other HPV virtually all remaining cases. Pooled testing for 13 oncogenic types, including HPV16 18, is currently used in clinical practice triage equivocal cytology and, conjunction with Pap tests, an option general screening among women 30 years age older. It not clear to what extent individual identifi cation or HPV18 as adjunct pooled might effectively identify at particularly high risk its immediate precursor, intraepithelial neoplasia 3 (CIN3). Methods: From April 1, 1989, November 2, 1990, a total 20 810 the Kaiser Permanente health plan Portland, OR, enrolled cohort study neoplasia. Women were tested by Hybrid Capture 2 (HC2), those positive HC2 test 18. Enrollment smear interpretation results linked histologically confi rmed CIN3 ( ≥ CIN3) occurring during 10 cytologic follow-up. We calculated cumulative incidence rates 95% dence intervals each interval up 122 months using Kaplan Meier methods. Results: The 10-year 17.2% (95% [CI] = 11.5% 22.9%) HPV16+ 13.6% CI 3.6% 23.7%) HPV18+ (HPV16 − ) women, but only 3.0% 1.9% 4.2%) HC2+ negative HPV18. was 0.8% 0.6% 1.1%). A subanalysis older normal enrollment strengthened observed differences. Conclusions: that distinguishes from may greatest permit less aggressive management infections. [J Natl Cancer Inst 2005;97:1072 9]