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This study aimed to assess the genotype\u2010specific impact of high\u2010risk human papillomavirus (HR\u2010HPV) infections on cervical cytological progression over a 3\u2010year interval among Chinese women, thereby providing evidence for more precise and individualized screening approaches. A multicenter cohort was established in 2017 across three Chinese provinces. Participants underwent baseline HPV genotyping and cytological examination, with genotyping for five high\u2010risk types (HPV16, 18, 33, 52, and 58), and follow\u2010up evaluations conducted from 2018 to 2020. Cytological progression was defined as a transition from normal cytology (negative for intraepithelial lesion or malignancy, NILM) at baseline to low\u2010grade squamous intraepithelial lesion (LSIL) or worse at the final follow\u2010up. A total of 7240 women were included to evaluate the cytological progression. The overall progression rate was 0.7%, with a notably higher rate among HR\u2010HPV\u2010positive women (2.1%) compared to HR\u2010HPV\u2010negative women (0.5%). Specifically, HPV16, HPV52, and HPV58 were significantly associated with an increased risk of progression, with adjusted odds ratios (aORs) of 6.26 (95% CI: 2.62\u201314.95), 6.68 (95% CI: 3.30\u201313.53), and 4.24 (95% CI: 1.51\u201311.94), respectively. Moreover, women with persistent infections with HPV16, HPV52, and HPV58 had approximately 8\u2010fold, 6\u2010fold, and 5\u2010fold higher risks of progression, respectively, compared with women without infections. Stratified management based on high\u2010risk genotypes\u2014particularly HPV16, HPV52, and HPV58\u2014may help prioritize colposcopy and more intensive follow\u2010up for women at elevated risk, which could contribute to cervical cancer prevention efforts.<\/jats:p>\n                  <jats:p>\n                    <jats:bold>Trial Registration:<\/jats:bold>\n                    Chinese Clinical Trial Registry Center of the World Health Organization International Clinical Trials Registry Platform number: ChiCRT2200055287\n                  <\/jats:p>","DOI":"10.1002\/cam4.71855","type":"journal-article","created":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T07:11:11Z","timestamp":1776755471000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Risk of 3\u2010Year Cytological Progression by Baseline\n                    <scp>HPV<\/scp>\n                    Status Among Women With Normal Cytology: A Multicenter Cohort Study"],"prefix":"10.1002","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-6476-1338","authenticated-orcid":false,"given":"Chong\u2010Bi","family":"Huang","sequence":"first","affiliation":[{"name":"Department of Epidemiology and Statistics, West China School of Public Health and West China Fourth Hospital Sichuan University  Chengdu China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guang\u2010Dong","family":"Liao","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, West China Second University Hospital &amp; Key Laboratory of Birth Defects and Related Diseases of Women and Children Sichuan University, Ministry of Education  Chengdu China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shao\u2010Kai","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Cancer Epidemiology and Prevention, Henan Engineering Research Center of Cancer Prevention and Control, Henan 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University  Chengdu China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-7461-8804","authenticated-orcid":false,"given":"Fan","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Statistics, West China School of Public Health and West China Fourth Hospital Sichuan University  Chengdu China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meng\u2010Yin","family":"Ao","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, West China Second University Hospital &amp; Key Laboratory of Birth Defects and Related Diseases of Women and Children Sichuan University, Ministry of Education  Chengdu China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Le\u2010Ni","family":"Kang","sequence":"additional","affiliation":[{"name":"National Office for Maternal and Child Health Surveillance, West China Second University Hospital Sichuan University  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