Risk of recurrent high-grade cervical intraepithelial neoplasia after successful treatment: a long-term multi-cohort study

Arguments in favor of HPV testing for cervical screening and post-treatment CIN2+ monitoring

“…The 5-year CIN2+ risk in women with negative co-testing at 6 and 24 months posttreatment is 1.0%. This risk is similar to that of women with normal cytology in population-based screening, which indicates that these double negative tested women could safely return to regular screening [31].…”

Long‐term follow‐up of the risk for cervical intraepithelial neoplasia grade 2 or worse in HPV‐negative women after conization

“…Two long-term studies did not find that HPV testing after conization was sufficiently safe for a return to a 5-year screening interval. 4,5 One of these studies, in North America, 4 also provided 3-year risk estimates for HPV-negative women at a 6-month visit posttreatment: the risk for CIN21 was markedly lower for women who tested negative for both cytology and HPV at the first post-conization visit than for those who tested negative for HPV alone, but it was still higher than the 0.68% risk estimate used as the benchmark for a 3-year return to routine screening (i.e., the risk of women with normal cytology in routine screening). Although our estimate of the risk for CIN21 relapse of women with negative HPV at the postconization visit (0.49%) is below the North American benchmark for 3-year return, comparisons on the basis of different populations should be made with caution.…”

“…Recognition of HR HPV as the prime causal factor of cervix cancer has led to addition of HPV to cytology in many followup programs; however, few studies have been published on HPV testing alone in long-term follow-up after conization. [3][4][5] In women in the general population, a negative HPV test has been shown to have high, long-term, negative predictive value for development of high-grade cervical lesions. 6,7 This has been studied less extensively, however, in women who have undergone conization; consequently, the long-term predictive value of a negative HPV test after conization is not known.…”

Secondary Prevention of Uterine Cervical Cancer

“…In ASC-US cases, HPV testing is performed for triage in the management of CIN, based on the results of available largescale clinical studies [10][11][12][13]. Furthermore, HPV typing has already been used as a biomarker for decisions on therapeutic interventions and subsequent follow-up of CIN [14][15][16][17][18][19]. Both the US and European guidelines recommended HPV testing to confirm the completion of treatment of CIN.…”