title: The ATHENA human papillomavirus study: design, methods, and baseline results.
abstract: OBJECTIVE
  The objective of the study was to describe baseline data from Addressing the Need for Advanced HPV Diagnostics, a prospective, multicenter US cervical cancer screening trial.
  
  
  METHODS
  A total of 47,208 women aged 21 years or older undergoing routine screening were enrolled; liquid-based cytology and human papillomavirus (HPV) testing were performed. Women with abnormal cytology underwent colposcopy, as did high-risk HPV (hrHPV)-positive women and a random subset of women negative by both tests aged 25 years or older. Verification bias adjustment was applied; 95% confidence intervals were computed by the bootstrap method.
  
  
  RESULTS
  The prevalence of cytologic abnormalities was 7.1%. hrHPV, HPV 16, and HPV 18 were detected using the cobas HPV Test in 12.6%, 2.8%, and 1.0% of women, respectively. Both cytologic abnormalities and hrHPV positivity declined with increasing age. The adjusted prevalence of cervical intraepithelial neoplasia grade 2 (CIN2) or greater in women aged 25-34 years was 2.3%, decreasing to 1.5% among older women.
  
  
  CONCLUSIONS
  The Addressing the Need for Advanced HPV Diagnostics study provides important estimates of the prevalence of cytologic abnormalities, hrHPV positivity, and CIN2 or greater in a US screening population.
authors.affiliation: Department of Pathology, College of Physicians and Surgeons, Columbia University, New York, NY, USA.
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Wright
authors.forename: Mark H
authors.initials: MH
authors.lastname: Stoler
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Behrens
authors.forename: Raymond
authors.initials: R
authors.lastname: Apple
authors.forename: Toniann
authors.initials: T
authors.lastname: Derion
authors.forename: Teresa L
authors.initials: TL
authors.lastname: Wright
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003127:Colposcopy / Q000379:methods; D003430:Cross-Sectional Studies; D055088:Early Detection of Cancer / Q000706:statistics & numerical data*; D005260:Female; D052162:Human papillomavirus 16 / Q000302:isolation & purification; D052161:Human papillomavirus 18 / Q000302:isolation & purification; D006801:Humans; D008875:Middle Aged; D030361:Papillomavirus Infections / Q000175:diagnosis / Q000821:virology; D015995:Prevalence; D011446:Prospective Studies; D012720:Severity of Illness Index; D014481:United States / Q000453:epidemiology; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology; D014626:Vaginal Smears / Q000379:methods; D055815:Young Adult; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology