{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T07:06:49Z","timestamp":1772694409820,"version":"3.50.1"},"reference-count":33,"publisher":"American Medical Association (AMA)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"Importance<\/jats:title>As US health care systems shift to human papillomavirus (HPV)\u2013based cervical cancer screening, more patients are receiving positive high-risk non\u201316\/18 genotype HPV results and negative for intraepithelial lesion or malignancy (NILM) cytological findings. Risk-based management guidelines recommend 2 consecutive negative annual results to return to routine screening.<\/jats:p><\/jats:sec>Objective<\/jats:title>To quantify patterns of surveillance testing and associated outcomes for patients after an HPV-positive results and NILM cytologic findings.<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>This cohort study analyzed patients in the METRICS (Multi-level Optimization of the Cervical Cancer Screening Process in Diverse Settings and Populations) cohort of the PROSPR II (Population-Based Research to Optimize the Screening Process) Cervical Consortium. Population-based data were obtained from 3 diverse health care systems (Mass General Brigham [MGB] in Massachusetts, Kaiser Permanente Washington [KPWA] in Washington, and Parkland Health [PH] in Texas) in the METRICS cohort. Participants were patients aged 21 to 65 years who received an HPV-positive (non-16\/18 or pooled genotypes) result and NILM cytologic finding from January 2010 to August 2018 and were followed up through December 2019. Data analyses were performed between April 2021 and November 2024.<\/jats:p><\/jats:sec>Main Outcomes and Measures<\/jats:title>Test receipt and outcomes delivered within 16 months after the index result (round 1 surveillance).<\/jats:p><\/jats:sec>Results<\/jats:title>The final sample across the 3 health care systems comprised 13\u202f158 female patients (3228 Hispanic or Latine [24.5%], 1990 non-Hispanic African American or Black [15.1%], 749 non-Hispanic Asian [5.7%], and 6559 non-Hispanic White [49.8%] individuals). Sociodemographic characteristics varied by site, with more non-Hispanic White (2277 [63.7%] and 4061 [61.2%]) and commercially insured patients (3137 [87.8%] and 4365 [65.7%]) at KPWA and MGB, and more Hispanic or Latine (1664 [56.5%]) and uninsured patients (2352 [79.9%]) at PH. During round 1 surveillance, 43.7% of patients were tested, of whom 18.2% (2394) had HPV-negative results and NILM cytologic findings and 25.5% (3351) had abnormal results. Many patients remained in the cohort and were untested through round 1 surveillance (overall: 49.4% [6505]; across sites: 39.0% [1395] to 69.4% [2043]), while fewer exited the cohort (overall: 6.9% [908]; across sites: 0.2% [12] to 24.6% [879]). Groups with lower odds of timely testing were younger adults (aged 25-29 vs 30-39 years: adjusted odds ratio [AOR], 0.65; 95% CL, 0.53-0.81), non-Hispanic African American or Black compared with non-Hispanic White patients (AOR, 0.78; 95% CL, 0.68-0.89), and those with Medicaid compared with commercial insurance (AOR, 0.81; 95% CL, 0.72-0.91), while those with a primary care clinician were more likely to have timely testing (AOR, 1.44; 95% CL, 1.21-1.70). Cancer was diagnosed in 10 patients (0.2%) untested in round 1 surveillance compared with 0 cancers in those with an HPV-negative results and NILM cytologic findings.<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>This cohort study found that among patients with HPV-positive results and NILM cytologic findings, less than half received a surveillance cotest during the guideline-recommended time frame. Health care systems should monitor annual surveillance and gather evidence on interventions to optimize the delivery of surveillance testing.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2024.54969","type":"journal-article","created":{"date-parts":[[2025,1,17]],"date-time":"2025-01-17T16:31:22Z","timestamp":1737131482000},"page":"e2454969","source":"Crossref","is-referenced-by-count":2,"title":["Delivering Guideline-Concordant Care for Patients With High-Risk HPV and Normal Cytologic Findings"],"prefix":"10.1001","volume":"8","author":[{"given":"Jasmin A.","family":"Tiro","sequence":"first","affiliation":[{"name":"Department of Public Health Sciences, Division of the Biological Sciences, The University of Chicago, Chicago, Illinois"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacquelyn M.","family":"Lykken","sequence":"additional","affiliation":[{"name":"Peter O\u2019Donnell School of Public Health, University of Texas Southwestern Medical Center, 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