title: Long-term follow-up of the risk for cervical intraepithelial neoplasia grade 2 or worse in HPV-negative women after conization.
abstract: Little research has been conducted on the long-term value of human papillomavirus (HPV) testing after conization. We investigated whether cytology adds to the value of a negative HPV test for long-term prediction of cervical intraepithelial neoplasia grade 2 or worse (CIN2+). In addition, we compared risk of CIN2+ following a negative HPV test in women after conization with that in women from the general population. During 2002-2005, 667 women treated for CIN2+ were tested for HPV and cytology 46 months after conization. Only HPV-negative women were included. Women participating in routine screening were age-matched with post-conization HPV-negative women, leaving 13,230 and 477 women, respectively, for analysis. By linkage to the Pathology Data Bank, we identified all cases of CIN2+ by December 2013. The 3-, 5-, 8- and 10-year risks for CIN2+ were 0.7, 0.9, 2.8 and 5.7% after a negative HPV test and 0.5, 0.8, 2.9 and 6.1% in HPV and cytology-negative women. HPV-negative women in the general population had similar 3-year and 5-year risks of 0.4 and 1.0%; thereafter, they had lower risks of 1.9% at 8 years and 2.7% at 10 years. Our results indicate that HPV testing may be used as a test of cure after conization. In the first 5 years after testing, the risk for CIN2+ of women who were HPV-negative at 34 months after conization was similar to that of HPV-negative women in the general population. After 67 years, however, women who have undergone conization may be at higher risk for CIN2+.
authors.affiliation: Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark.
authors.forename: Camilla F
authors.initials: CF
authors.lastname: Gosvig
authors.affiliation: Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark.
authors.forename: Lene D
authors.initials: LD
authors.lastname: Huusom
authors.affiliation: Unit of Statistics, Bioinformatics and Registry, Danish Cancer Society Research Center, Copenhagen, Denmark.
authors.forename: Klaus K
authors.initials: KK
authors.lastname: Andersen
authors.affiliation: Unit of Statistics, Bioinformatics and Registry, Danish Cancer Society Research Center, Copenhagen, Denmark.
authors.forename: Anne Katrine
authors.initials: AK
authors.lastname: Duun-Henriksen
authors.affiliation: Unit of Statistics, Bioinformatics and Registry, Danish Cancer Society Research Center, Copenhagen, Denmark.
authors.forename: Kirsten
authors.initials: K
authors.lastname: Frederiksen
authors.affiliation: Experimental Virology Section, Universitaetsklinikum Tuebingen, Tuebingen, Germany.
authors.forename: Angelika
authors.initials: A
authors.lastname: Iftner
authors.affiliation: Private Gynecological Clinic, Elsinore, Denmark.
authors.forename: Edith
authors.initials: E
authors.lastname: Svare
authors.affiliation: Experimental Virology Section, Universitaetsklinikum Tuebingen, Tuebingen, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Iftner
authors.affiliation: Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark.|Department of Gynecology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
authors.forename: Susanne K
authors.initials: SK
authors.lastname: Kjaer
mesh_terms: D000328:Adult; D002584:Cervix Uteri / Q000473:pathology; D019092:Conization; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D060787:Neoplasm Grading; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control* / Q000821:virology; D030361:Papillomavirus Infections / Q000175:diagnosis; D011446:Prospective Studies; D012307:Risk Factors; D055815:Young Adult; D002578:Uterine Cervical Dysplasia / Q000473:pathology / Q000601:surgery* / Q000821:virology
keywords: cervical intraepithelial neoplasia; conization; human papillomavirus; long-term follow-up