The influence of type-specific human papillomavirus infections on the detection of cervical precancer and cancer: A population-based study of opportunistic cervical screening in the United States.

摘要: There are limited data on the prospective risks of detecting cervical precancer and cancer in United States (US) populations specifically where delivery opportunistic screening takes place outside managed care absence organized national programs. Such will inform management women with positive results before after widespread human papillomavirus (HPV) vaccination establishes a baseline preceding recent changes US guidelines. Using reported to statewide passive surveillance systems New Mexico HPV Pap Registry, we measured 3-year type-specific cumulative incidence intraepithelial neoplasia grade 2 or more severe (CIN2+) 3 (CIN3+) detected during real-world health across diversity organizations, payers, clinical settings, providers patients. A stratified sample 47,541 cytology specimens from population 379,000 underwent genotyping. Three-year for different combinations cytologic interpretation risk group ranged <1% (for several combinations) approximately 70% CIN2+ 55% CIN3+ high-grade (HSIL) HPV16 infection. substantial proportion (35.7%) (30.9%) were diagnosed following negative cytology, which 62.3 78.2%, respectively, high-risk positive. had greatest (10.9% CIN2+,8.0% CIN3+) followed by HPV33, HPV31, HPV18. Positive HPV, especially HPV16, severity interpretation, age contribute independently CIN3+.