title: Negative HPV testing among patients with biopsy-proven cervical intraepithelial neoplasia grade 2/3 or cervical cancer.
abstract: OBJECTIVE
  To determine the proportion of patients diagnosed with cervical cancer or cervical intraepithelial neoplasia grade 2 or 3 (CIN 2/3) despite testing negative for HPV.
  
  
  METHODS
  A prospective study was conducted at a university hospital in Barcelona, Spain, between March 2003 and January 2015 among women with abnormal cytology results according to the Bethesda classification system. All participants underwent HPV testing, cytology, and colposcopy.
  
  
  RESULTS
  Among 1376 participants, 609 (44.3%) were diagnosed with CIN 2/3. Of these women, 74 (12.2%) tested negative for HPV. Among 479 women with colposcopy-guided biopsy sampling showing CIN 2/3, cone biopsy results that were negative for CIN 2/3 were more frequent among patients with negative HPV testing (13/61 [21.3%]) than among those with positive HPV tests (58/418 [13.9%]; P=0.03). Additionally, among 59 patients diagnosed with cervical cancer, 9 (15.3%) tested negative for HPV.
  
  
  CONCLUSIONS
  The HPV test was negative for 12% and 15% of patients diagnosed with biopsy-proven CIN 2/3 and cervical cancer, respectively.
authors.affiliation: Obstetrics and Gynecology, Universitary Hospital Sant Joan de Deu, Barcelona, Spain.
authors.forename: Eduardo
authors.initials: E
authors.lastname: González-Bosquet
authors.affiliation: Obstetrics and Gynecology, Universitary Hospital Sant Joan de Deu, Barcelona, Spain.
authors.forename: Sergi
authors.initials: S
authors.lastname: Fernandez
authors.affiliation: Barcelona Center for Maternal Fetal and Neonatal Medicine, Fetal i+D Fetal Medicine Research Center, Hospital Clinic, Hospital Sant Joan de Deu, University of Barcelona, Barcelona, Spain.
authors.forename: Sally
authors.initials: S
authors.lastname: Sabra
authors.affiliation: Obstetrics and Gynecology, Universitary Hospital Sant Joan de Deu, Barcelona, Spain.
authors.forename: Jose M
authors.initials: JM
authors.lastname: Lailla
mesh_terms: D000328:Adult; D002584:Cervix Uteri / Q000473:pathology; D003127:Colposcopy; D019092:Conization / Q000706:statistics & numerical data*; D005260:Female; D006785:Hospitals, University; D006801:Humans; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D027383:Papillomaviridae / Q000235:genetics; D030361:Papillomavirus Infections / Q000150:complications / Q000175:diagnosis*; D011446:Prospective Studies; D013030:Spain; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000473:pathology*; D055815:Young Adult; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis / Q000473:pathology*
keywords: Biopsy sampling; Cervical cancer; Cervical intraepithelial neoplasia; HPV infection; HPV test; Screening