Three-year risk of cervical precancer and cancer after the detection of low-risk human papillomavirus genotypes targeted by a commercial test.
OBJECTIVE
To investigate the risk of cervical precancer and cancer associated with detection of human papillomavirus (HPV) 6, 11, and 42.


METHODS
We used data from the New Mexico Human Papillomavirus Pap Registry. A stratified sample of 59,644 residual cervical cytology specimens from a population of 379,000 underwent HPV genotyping. We measured the 3-year cumulative incidence of cervical intraepithelial neoplasia grade 2 or more severe (CIN 2+) and grade 3 or more severe (CIN 3+) after detection of single HPV 6, 11, or 42 infections or single or multiple infections of HPV 6, 11, or 42 ("HPV 6, 11, 42, or combinations"; n=581).


RESULTS
The overall prevalence of a single infection of HPV 6, 11, or 42 was 0.8% (95% confidence interval [CI] 0.7-0.9%). The 3-year risks of CIN 2+ and CIN 3+ after HPV 6, 11, 42, or combinations infections (n=581) were 0.4% (CI 0.1-0.7%) for CIN 2+ and 0.0% for CIN 3+ (nota bene, no CI was calculable because no events occurred), respectively. By comparison, the 3-year risks of CIN 2+ and CIN 3+ after a negative HPV result (n=27,522) were 0.2% (95% CI 0.1-0.2%) and 0.1% (95% CI 0.0-0.1%), respectively.


CONCLUSIONS
Detection of HPV 6, 11, 42, or combinations in the absence of high-risk HPV types does not identify women at increased 3-year risk for cervical precancer. Testing for HPV 6, 11, 42, or combinations of those types should be discontinued because it has no proven benefit to patients.


METHODS
II.
Albert Einstein College of Medicine, New York, New York; and the University of New Mexico Health Sciences Center, Departments of Pathology and Obstetrics and Gynecology, House of Prevention Epidemiology, Albuquerque, New Mexico.
Philip E
PE
Castle
William C
WC
Hunt
Erika
E
Langsfeld
Cosette M
CM
Wheeler
D000328:Adult; D005260:Female; D052140:Human papillomavirus 11; D006801:Humans; D009516:New Mexico / Q000453:epidemiology; D030361:Papillomavirus Infections / Q000150:complications* / Q000453:epidemiology / Q000235:genetics; D018570:Risk Assessment; D002578:Uterine Cervical Dysplasia / Q000453:epidemiology / Q000821:virology*; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology / Q000821:virology*