title: hr-HPV testing in the follow-up of women with cytological abnormalities and negative colposcopy.
abstract: BACKGROUND
  The follow-up after abnormal Pap smear and negative colposcopy is not clearly defined. This study aimed at investigating the role of hr-HPV testing in the management of abnormal Pap test and negative colposcopy for Cervical Intraepithelial Neoplasia grade 2 or worse (CIN2+). methods: The study enrolled 1029 women with abnormal screening cytology (years 2006-2010) and negative colposcopy for CIN2+, which subsequently performed a hr-HPV test. Incident CIN2+ lesions were identified through linkage with cancer registry, hospital discharge records, neoplastic pathology reports and the archive of screening programme (2006-2011).
  
  
  RESULTS
  During the follow-up, the cohort developed 133 CIN2+ lesions; only one among hr-HPV-negative women. The probability of developing CIN2+ on follow-up time was 0.44% (95% confidence interval (CI) 0.1-3.1) and 41.8% (95% CI 31.8-53.5) for hr-HPV-negative women and hr-HPV-positive women, respectively. A woman with a positive hr-HPV test had about 105 times higher probability of developing a CIN2+ lesion than a woman with a negative hr-HPV test (hazard ratio (HR)=104.5, 95% CI 14.5-755.1), adjusted for index Pap test result, age and cervix squamocolumnar junction visualisation.
  
  
  CONCLUSIONS
  Our results confirm that hr-HPV testing is able to select the real group of women at risk of developing CIN2+ lesions in the follow-up of abnormal cytology and first negative colposcopy.
authors.affiliation: Analytical Cytology and Biomolecular Unit, Istituto per lo Studio e la Prevenzione Oncologica, Florence 50139, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Carozzi
authors.forename: C B
authors.initials: CB
authors.lastname: Visioli
authors.forename: M
authors.initials: M
authors.lastname: Confortini
authors.forename: A
authors.initials: A
authors.lastname: Iossa
authors.forename: P
authors.initials: P
authors.lastname: Mantellini
authors.forename: E
authors.initials: E
authors.lastname: Burroni
authors.forename: M
authors.initials: M
authors.lastname: Zappa
mesh_terms: D000328:Adult; D003127:Colposcopy; D003584:Cytological Techniques; D004279:DNA, Viral / Q000302:isolation & purification; D005260:Female; D006801:Humans; D008875:Middle Aged; D027383:Papillomaviridae / Q000302:isolation & purification; D030361:Papillomavirus Infections / Q000175:diagnosis* / Q000821:virology; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000821:virology; D014626:Vaginal Smears; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis* / Q000821:virology*
chemical_list: D004279:DNA, Viral