{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T13:23:17Z","timestamp":1790688197412,"version":"4.1.0"},"reference-count":45,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2024,6,3]],"date-time":"2024-06-03T00:00:00Z","timestamp":1717372800000},"content-version":"vor","delay-in-days":2,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100019018","name":"Chinese Academy of Medical Sciences Initiative for Innovative Medicine","doi-asserted-by":"publisher","award":["2021\u2010I2M\u20101\u2010004"],"award-info":[{"award-number":["2021\u2010I2M\u20101\u2010004"]}],"id":[{"id":"10.13039\/501100019018","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To assess the clinical values of extended human papillomavirus (HPV) genotyping in triage of high\u2010risk HPV\u2010positive women, focusing on the trade\u2010off between cervical precancer detections and colposcopy referrals.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A bivariate random\u2010effects model was used to estimate the diagnostic accuracy of primary HPV screening with following triage strategies to detect cervical precancers: (i) partial genotyping for HPV16\/18 combined with cytological testing at atypical squamous cells of undetermined significance threshold (used as the comparator), (ii) genotyping for HPV16\/18\/58\/52, (iii) genotyping for HPV16\/18\/58\/52\/33, (iv) genotyping for HPV16\/18\/58\/33\/31, (v) genotyping for HPV16\/18\/58\/52\/33\/31, and (vi) genotyping for HPV16\/18\/58\/52\/33\/31\/39\/51. Internal risk benchmarks for clinical management were used to evaluate the risk stratification of each triage strategy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 16,982 women (mean age 46.1\u2009years, range 17\u201369) were included in this analysis. For CIN3+ detection, triage with HPV16\/18\/58\/33\/31 genotyping achieved lower positivity (6.85% vs. 7.35%, <jats:italic>p<\/jats:italic>\u2009=\u20090.001), while maintaining similar sensitivity (91.35% vs. 96.42%, <jats:italic>p<\/jats:italic>\u2009=\u20090.32) and specificity (94.09% vs. 93.67%, <jats:italic>p<\/jats:italic>\u2009=\u20090.56) compared with the comparator strategy. Similar patterns were observed for CIN2+ detection. Women with a positive HPV16\/18\/58\/33\/31 genotyping test had high enough risk for CIN3+ for colposcopy referral, while the risk for women with a negative test was below the 1\u2010year return decision threshold according to internal benchmarks.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our findings suggested extended HPV genotyping is of potential to be used as a triage technique integrated into HPV\u2010based cervical cancer screening, leading to reduced need for colposcopy referral while maintaining similar disease detection and efficient risk stratification.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cam4.7316","type":"journal-article","created":{"date-parts":[[2024,6,3]],"date-time":"2024-06-03T08:49:18Z","timestamp":1717404558000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Clinical evaluation of primary human papillomavirus (HPV) testing with extended <scp>HPV<\/scp> genotyping triage for cervical cancer screening: A pooled analysis of individual patient data from nine population\u2010based cervical cancer screening studies from China"],"prefix":"10.1002","volume":"13","author":[{"given":"Changchang","family":"Dun","sequence":"first","affiliation":[{"name":"Department of Population Medicine, School of Population Medicine and Public Health Chinese Academy of Medical Sciences and Peking Union Medical College  Beijing China"},{"name":"Department of Epidemiology, National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meiwen","family":"Yuan","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuelian","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shangying","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Arbyn","sequence":"additional","affiliation":[{"name":"Unit of Cancer Epidemiology, Belgian Cancer Centre Scientific Institute of Public Health  Brussels Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9294-0005","authenticated-orcid":false,"given":"Fanghui","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Population Medicine, School of Population Medicine and Public Health Chinese Academy of Medical Sciences and Peking Union Medical College  Beijing China"},{"name":"Department of Epidemiology, National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,6,3]]},"reference":[{"key":"e_1_2_10_2_1","volume-title":"Global Strategy to Accelerate the Elimination of Cervical Cancer as a Public Health Problem","author":"World Health Organization (WHO)","year":"2020"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.30468"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2012.06.095"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.20244"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/s2214-109x(22)00241-8"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2007.07.049"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2014.12.022"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2019.0306"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2021.02.017"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.31261"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41379-022-01052-4"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/s2214-109x(19)30482-6"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcv.2015.11.015"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwp188"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.33001"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/s1470-2045(10)70256-4"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.32881"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.d2757"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.33290"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.287.16.2114"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jviromet.2015.01.001"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcv.2017.12.001"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.27571"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1006\/gyno.2001.6370"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2018.09.012"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/9781119756194"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-158-7-201304020-00006"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.7326\/m15-2735"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2022.7032"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1002\/jrsm.1634"},{"key":"e_1_2_10_32_1","unstructured":"PartlettC TakwoingiY.Meta\u2010analysis of test accuracy studies in R: a summary of user\u2010written programs and step\u2010by\u2010step guide to using glmer. Version 2.0.2021Accessed July 1 2023.http:\/\/methods.cochrane.org\/sdt\/"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1086\/657321"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.27485"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.2196\/38628"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcp\/aqab181"},{"key":"e_1_2_10_37_1","doi-asserted-by":"publisher","DOI":"10.1002\/jmv.28302"},{"key":"e_1_2_10_38_1","doi-asserted-by":"publisher","DOI":"10.1002\/jmv.27013"},{"key":"e_1_2_10_39_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2023.1130226"},{"key":"e_1_2_10_40_1","doi-asserted-by":"publisher","DOI":"10.1097\/LGT.0b013e318285423c"},{"key":"e_1_2_10_41_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djr283"},{"key":"e_1_2_10_42_1","doi-asserted-by":"publisher","DOI":"10.1158\/1940-6207.Capr-17-0088"},{"key":"e_1_2_10_43_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djv389"},{"key":"e_1_2_10_44_1","doi-asserted-by":"publisher","DOI":"10.1016\/s1470-2045(11)70188-7"},{"key":"e_1_2_10_45_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2019.15781"},{"key":"e_1_2_10_46_1","doi-asserted-by":"publisher","DOI":"10.1097\/lgt.0000000000000525"}],"updated-by":[{"DOI":"10.1002\/cam4.7451","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2024,7,5]],"date-time":"2024-07-05T00:00:00Z","timestamp":1720137600000}}],"container-title":["Cancer Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cam4.7316","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,6,28]],"date-time":"2024-06-28T12:20:38Z","timestamp":1719577238000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/cam4.7316"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6]]},"references-count":45,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2024,6]]}},"alternative-id":["10.1002\/cam4.7316"],"URL":"https:\/\/doi.org\/10.1002\/cam4.7316","archive":["Portico"],"relation":{"correction":[{"id-type":"doi","id":"10.1002\/cam4.7451","asserted-by":"object"}]},"ISSN":["2045-7634","2045-7634"],"issn-type":[{"value":"2045-7634","type":"print"},{"value":"2045-7634","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,6]]},"assertion":[{"value":"2023-12-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-05-07","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-06-03","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e7316"}}