Screening for persistent high-risk HPV infections may be a valuable screening method for young women; A retrospective cohort study

• Published in: PloS one 2018-10, Vol.13 (10), p.e0206219-e0206219
• Main Authors: Ebisch, Renée M F, Ketelaars, Pleun J W, van der Sanden, Wouter M H, Schmeink, Channa E, Lenselink, Charlotte H, Siebers, Albert G, Massuger, Leon F A G, Melchers, Willem J G, Bekkers, Ruud L M
• Format: Article
• Language: English
• Subjects: Age; Analysis; Biology and Life Sciences; Care and treatment; Cellular biology; Cervical cancer; Cervix; Cohort analysis; Cytology; Data processing; Diagnosis; Genotyping; Gynecology; Health aspects; Health risk assessment; Health risks; Histology; Human papillomavirus; Infections; Lesions; Medical diagnosis; Medical screening; Medicine and Health Sciences; Methods; Obstetrics; Papillomavirus infections; Pathology; People and places; Persistent infection; Polymerase chain reaction; Prevalence studies (Epidemiology); Risk; Risk factors; Test procedures; Vagina; Women
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0206219

Screening of young women is often discouraged because of the high risk of unnecessary diagnostics or overtreatment. Multiple countries therefore use cytology instead of high risk human papillomavirus (hrHPV)-testing as screening method for young women because of the limited specificity of hrHPV-testing. The objective of this study was to investigate how hrHPV screening before the age of 30, can be used to reduce the future prevalence of high-grade cervical lesions in young women. We retrospectively analyzed follow-up data from a cohort study on HPV prevalence in unscreened Dutch women aged 18-29 years. Women performed multiple self-collected cervico-vaginal samples for HPV detection and genotyping. At least one valid cervical pathology result was obtained from 1,018 women. Women were categorized as hrHPV negative, cleared- or persistent hrHPV infection. Anonymized follow-up data for each group was obtained. Composite outcome measures were defined as; normal, low-grade squamous intraepithelial lesion (LSIL) or high-grade squamous intraepithelial lesion (HSIL). The association between prior hrHPV status and cytology and histology outcome was analyzed. After exclusion, a pathology result was registered for 962 women. The prevalence of HSIL was 19.3% in women with a persistent HPV infection at a younger age. This is significantly higher (p