title: Five-year experience of human papillomavirus DNA and Papanicolaou test cotesting.
abstract: OBJECTIVE
  To estimate the 5-year age group-specific test positives for Pap tests and human papillomavirus (HPV) testing in a large, general screening population of women 30 and older.
  
  
  METHODS
  Using data from Kaiser Permanente Northern California, a large health maintenance organization that introduced cotesting in 2003, we evaluated the cotesting results overall and by 5-year age groups. Women (n=580,289) who opted for and underwent cotesting (n cotests=812,598) between January 2003 and April 2008 were included in the analysis. Pap tests interpreted as atypical squamous cells of undetermined significance (ASC-US) or more severe were considered to be positive. Women were tested for carcinogenic HPV using an assay approved by the U.S. Food and Drug Administration. Binomial exact 95% confidence intervals (CIs) were calculated.
  
  
  RESULTS
  Overall, 6.27% (95% CI 6.21-6.32%) of cotests were carcinogenic HPV positive, and only 3.99% (95% CI 3.94-4.03%) cotests had normal cytology and were carcinogenic HPV positive. By comparison, 5.18% (95% CI 5.13-5.23%) of cotests had ASC-US or more severe cytology, and 2.87% (95% CI 2.84-2.91%) of cotests had ASC-US or more severe cytology and were carcinogenic HPV negative.
  
  
  CONCLUSIONS
  In a general screening population, concerns about excessive HPV test positives among women aged 30 years and older are not borne out.
authors.affiliation: From the Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland; Regional Laboratory, Kaiser Permanente Northern California, Berkeley, California; Women's Health Research Institute and Division of Gynecologic Oncology, Kaiser Permanente Medical Care Program, Oakland, California.
authors.forename: Philip E
authors.initials: PE
authors.lastname: Castle
authors.forename: Barbara
authors.initials: B
authors.lastname: Fetterman
authors.forename: Nancy
authors.initials: N
authors.lastname: Poitras
authors.forename: Thomas
authors.initials: T
authors.lastname: Lorey
authors.forename: Ruth
authors.initials: R
authors.lastname: Shaber
authors.forename: Walter
authors.initials: W
authors.lastname: Kinney
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D006801:Humans; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D065006:Papanicolaou Test; D027383:Papillomaviridae / Q000235:genetics; D030361:Papillomavirus Infections / Q000175:diagnosis* / Q000453:epidemiology; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000821:virology; D014626:Vaginal Smears / Q000379:methods
chemical_list: D004279:DNA, Viral