BACKGROUND: High-risk @entity1082 (HR-HPV) testing has become a preferred @entity5 screening strategy in some countries due to its superior sensitivity over cytology-based methods for identifying @entity3146 or worse (CIN2+). Improved sensitivity has been accompanied by reductions in specificity and concerns regarding over-screening and over-treatment of @entity1 with @entity1083 . Triage of HR-HPV+ @entity1 to colposcopy is, thus, warranted for appropriate management and treatment. METHODS: Using data from the Canadian @entity5 Screening Trial (CCCaST), we compared the performance of cytology and HR-HPV strategies to detect CIN2+ among HR-HPV+ @entity1 (age=30-69 years). Colposcopy referral rates and performance gains from adding other HR-HPV genotypes to @entity1799 /18+ triage were also evaluated. RESULTS: A strategy referring all @entity1799 /18+ and @entity1799 /18- but ASC-US+ @entity1 had the highest sensitivity (82.5%; 95% CI: 70.9-91.0), but yielded the highest colposcopy referral rate. @entity1799 /18+ triage was the next most sensitive strategy (64.1%; 95% CI: 51.1-75.7). LSIL+ cytology triage yielded a low sensitivity (32.8%; 95% CI: 21.9-45.4), but had the most favorable specificity (93.6%; 95% CI: 91.0-95.6), positive predictive value (41.5%; 95% CI: 28.1-55.9), and colposcopy referral rate of strategies examined. HPV viral load triage strategies did not perform optimally overall. Inclusion of HR-HPV genotypes 31 and 52 to @entity1799 /18+ triage provided the highest sensitivities. CONCLUSION: Concerns surrounding HPV-based screening can be effectively mitigated via triage. IMPACT: Balancing the benefits of HPV-based primary cervical screening with informed management recommendations for HR-HPV+ @entity1 may decide the success of its widening utilization.

COMPARISON OF TRIAGE STRATEGIES FOR HPV POSITIVE XXXX : CANADIAN CERVICAL CANCER SCREENING TRIAL RESULTS.

@entity1 :: ('9606', 'Species') :: ['women'] @entity5 :: ('MESH:D009369', 'Disease') :: ['cervical cancer', 'Cervical Cancer'] @entity1083 :: ('MESH:D030361', 'Disease') :: ['transient or non-progressing HR-HPV infections'] @entity1799 :: ('333760', 'Species') :: ['HPV16'] @entity1082 :: ('10566', 'Species') :: ['human papillomavirus'] @entity3146 :: ('MESH:D018290', 'Disease') :: ['cervical intraepithelial neoplasia of grade 2']
@entity1 :: (9606,Species) :: ['WOMEN']
