title: A whole-population profile of HPV testing as a test of cure for high-grade cervical dysplasia in NSW, Australia.
abstract: BACKGROUND
  Few population-based studies have been conducted on the efficacy of human papilloma virus (HPV) testing as a test of cure for high grade cervical dysplasia.
  
  
  METHODS
  A cohort of women (n = 11,521) with high grade (CIN2+) cervical dysplasia diagnosed during 2006-2010, who also had accompanying HPV testing (n = 19,434 HPV tests), was analyzed with respect to National Health and Medical Research Council (NHMRC) follow-up guidelines. Cure rates, and number of follow-up tests and times to reach a cure were estimated.
  
  
  RESULTS
  In the ≥2-years following high grade dysplasia, 53% of women had a single follow-up HPV test, 33% had two, and 14% had three or more HPV follow-up tests. 75% of women with follow-up HPV and cytology testing according to NHMRC guidelines were cured (2,210 from 2,948). Cure rates were lowest in those aged <30 (71%) and highest in women aged 30-49 (80%). Of those cured, 68% attained cure by the second HPV test, 21% by the third, and 11% at the fourth or later HPV test. The median time to cure was 1,097 days. In non-cured women, 56% of test results originated from all-negative cytology with positive HPV, compared with 9% from all-negative HPV results.
  
  
  CONCLUSIONS
  Cure rates in women with follow-up testing according to NHMRC guidelines are high. Further studies are needed of the high proportion of women with negative cytology classed as not cured due to HPV positivity, and of the high proportion of women with high grade dysplasia who had one follow-up HPV test only.
authors: Cancer Institute NSW, Level 9, 8 Central Avenue, Australian Technology Park, Sydney, NSW, Australia School of Public Health and Community Medicine, UNSW, Kensington, NSW, Australia stephen.morrell@unsw.edu.au.
authors: Stephen
authors: S
authors: Morrell
authors: Cancer Institute NSW, Level 9, 8 Central Avenue, Australian Technology Park, Sydney, NSW, Australia.
authors: Liping
authors: L
authors: Qian
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008875:Middle Aged; D009517:New South Wales / Q000453:epidemiology; D027383:Papillomaviridae; D030361:Papillomavirus Infections / Q000175:diagnosis* / Q000453:epidemiology; D002578:Uterine Cervical Dysplasia / Q000453:epidemiology* / Q000473:pathology* / Q000628:therapy / Q000821:virology
keywords: cervical dysplasia; cytology; hpv testing; human papilloma virus; test of cure