{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T12:04:26Z","timestamp":1769515466914,"version":"3.49.0"},"reference-count":22,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2019,10,7]],"date-time":"2019-10-07T00:00:00Z","timestamp":1570406400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Cytopathology"],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>High\u2010risk human papillomavirus (HPV)\u2013Papanicolaou (Pap) cotesting is recommended for cervical cancer screening in women aged \u226530\u00a0years. The current study analyzed the effectiveness of cotesting on risk management in different age groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective review of a 5\u2010year cytology database identified 9434 women with HPV\u2010Pap cotesting and follow\u2010up cervical biopsy. The 3\u2010year cumulative risk of developing high\u2010grade cervical lesions (\u2265high\u2010grade squamous intraepithelial lesion [HSIL]) was analyzed using age stratification.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The 3\u2010year cumulative risk of developing \u2265HSIL was found to be significantly different in women with baseline cotesting HPV\u2010positive and Pap\u2010positive results (HPV+\/Pap+; defined as \u2265atypical squamous cells of undetermined significance), HPV+ and Pap\u2010negative results, and HPV\u2010negative and Pap+ results at 19.2%, 7.9%, and 3.1%, respectively (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001). The risk of \u2265HSIL peaked at ages 30 to 39\u00a0years and significantly decreased at ages 50 to 59\u00a0years (16.6% vs 6.7%; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001). Women aged &lt;30\u00a0years shared a high risk similar to that of women aged 30 to 39\u00a0years (17.3% vs 16.6%; <jats:italic>P<\/jats:italic>\u00a0=\u00a0.52), and risk stratification by cotesting was found to be equally effective in the younger age group (HPV+ and Pap+: 19.6%; HPV+ and Pap\u2010negative: 7.2%; and HPV\u2010negative and Pap+: 4.4% [<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001]).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>High\u2010risk HPV\u2013Pap cotesting appears to be extremely sensitive for the prediction of the risk of developing \u2265HSIL and is an effective tool for risk stratification. In the current study, the 3\u2010year cumulative risk of developing \u2265HSIL varied significantly with age, with the highest risk noted among women aged &lt;40\u00a0years and the lowest risk observed in women aged 50 to 59\u00a0years. Pap testing significantly impacted risk stratification in the HPV+ positive group, especially in women aged &lt;60\u00a0years. Women aged &lt;30\u00a0years were found to have a risk profile and cotesting efficacy similar to those of women aged 30 to 39\u00a0years. Modification of the current recommendation to offer cotesting to women aged \u226530\u00a0years might be considered to include those patients aged &lt;30\u00a0years.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncy.22192","type":"journal-article","created":{"date-parts":[[2019,10,7]],"date-time":"2019-10-07T10:10:11Z","timestamp":1570443011000},"page":"757-764","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Age\u2010specific 3\u2010year cumulative risk of cervical cancer and high\u2010grade dysplasia on biopsy in 9434 women who underwent HPV cytology cotesting"],"prefix":"10.1002","volume":"127","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5462-3698","authenticated-orcid":false,"given":"Yimin","family":"Ge","sequence":"first","affiliation":[{"name":"Department of Pathology and Genomic Medicine Houston Methodist Hospital Houston Texas"},{"name":"Weill Medical College of Cornell University New York New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul A.","family":"Christensen","sequence":"additional","affiliation":[{"name":"Department of Pathology and Genomic Medicine Houston Methodist Hospital Houston Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric","family":"Luna","sequence":"additional","affiliation":[{"name":"BioReference Laboratories Houston Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Donna","family":"Armylagos","sequence":"additional","affiliation":[{"name":"BioReference Laboratories Houston Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiaqiong","family":"Xu","sequence":"additional","affiliation":[{"name":"Weill Medical College of Cornell University New York New York"},{"name":"Center for Outcomes Research and DeBakey Heart and Vascular Center Houston Methodist Hospital Research Institute Houston Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jim W.","family":"Hsu","sequence":"additional","affiliation":[{"name":"Department of Pathology and Genomic Medicine Houston Methodist Hospital Houston Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haijun","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Pathology and Genomic Medicine Houston Methodist Hospital Houston Texas"},{"name":"Weill Medical College of Cornell University New York New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary R.","family":"Schwartz","sequence":"additional","affiliation":[{"name":"Department of Pathology and Genomic Medicine Houston Methodist Hospital Houston Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dina R.","family":"Mody","sequence":"additional","affiliation":[{"name":"Department of Pathology and Genomic Medicine Houston Methodist Hospital Houston Texas"},{"name":"Weill Medical College of Cornell University New York New 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