title: Short-term risk of cervical intraepithelial neoplasia grades 2 and 3 for women with normal cytology and human papillomavirus infection.
abstract: OBJECTIVE
  To assess the risk of cervical intraepithelial neoplasia grades 2, 3 or higher (CIN 2/3+) for women with normal cytology and concurrent high-risk human papillomavirus infection (HR-HPV).
  
  
  METHODS
  We examined 2 200 women every 6 months for an average of 9 years. Cervical smears and samples for HPV DNA were obtained at each visit. Absolute risk of subsequent CIN2/CIN3+ was estimated using the Kaplan-Meier method.
  
  
  RESULTS
  The absolute risk of CIN2/CIN3+ among HR-HPV-positive women with normal Pap smear results was 1.06% (95%CI, 0.57-2.20), 5 times higher the risk among all women with normal Pap smears (0.20%; 95%CI, 0.12-0.32) but 7 times lower than that for women with HR-HPV infection and LSIL (7.24%; 95%CI, 3.78-15.2).
  
  
  CONCLUSIONS
  Short-term absolute risk of CIN2/3+ after a normal Pap smear with concurrent HR-HPV infection is low (~1%), suggesting that the HR-HPV test has limited utility in short-term clinical decision-making for women with normal cytology.
authors.affiliation: Instituto Nacional de Cancerología, Bogotá, Colombia. gahernandez@cancer.gov.co
authors.forename: Gustavo
authors.initials: G
authors.lastname: Hernández-Suárez
authors.forename: Natasha
authors.initials: N
authors.lastname: Ortiz
authors.forename: Mauricio
authors.initials: M
authors.lastname: González
authors.forename: Nubia
authors.initials: N
authors.lastname: Muñoz
mesh_terms: D000293:Adolescent; D000328:Adult; D052685:Alphapapillomavirus / Q000302:isolation & purification* / Q000472:pathogenicity; D015331:Cohort Studies; D003105:Colombia / Q000453:epidemiology; D003278:Contraceptives, Oral, Hormonal / Q000009:adverse effects; D004279:DNA, Viral / Q000032:analysis; D018450:Disease Progression; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D016017:Odds Ratio; D065006:Papanicolaou Test; D030361:Papillomavirus Infections / Q000473:pathology*; D011230:Precancerous Conditions / Q000473:pathology* / Q000821:virology; D011379:Prognosis; D011446:Prospective Studies; D012306:Risk; D012907:Smoking / Q000453:epidemiology; D002575:Uterine Cervicitis / Q000473:pathology* / Q000821:virology; D014626:Vaginal Smears; D055815:Young Adult; D002578:Uterine Cervical Dysplasia / Q000453:epidemiology* / Q000821:virology
chemical_list: D003278:Contraceptives, Oral, Hormonal; D004279:DNA, Viral