{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T02:24:52Z","timestamp":1771035892877,"version":"3.50.1"},"reference-count":24,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,11,5]],"date-time":"2024-11-05T00:00:00Z","timestamp":1730764800000},"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":[[2025,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>In 2019, the American Society for Colposcopy and Cervical Pathology introduced fundamental shifts toward \u201crisk\u2010based\u201d guidelines, with human papillomavirus (HPV) genotyping as a principal test for investigating squamous intraepithelial lesions. This study aims to provide practice\u2010based evidence and supplement the updated guidelines by investigating HPV demographic distribution and uncovering the pathological features of high\u2010grade squamous intraepithelial lesions (HSILs) caused by high\u2010risk HPV (hrHPV) subtypes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients who underwent Papanicolaou screening and HPV testing in two hospital systems over the course of 4 years were recruited. The cytology results were categorized on the basis of the 2014 Bethesda classification. DNA sequences of 14 types of hrHPV were detected by Aptima test. The histological features of HSILs caused by different subtypes were compared between biopsies and excisions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 63,709 cases were included. The HPV prevalence was 14.70%, predominantly in the 30 to 39\u2010year\u2010old age group, with slightly higher rates observed in African Americans. There was no significant racial distribution difference between HPV 16\/18\/45 and other types. HPV 16\/18\/45 infection was directly correlated with the severity of abnormal cytology, although the other subtypes were the major causes of cytological abnormalities. The trend for HPV prevalence was consistent across calendar years, and was associated with 8.77% negative for intraepithelial lesion or malignancy, 30.46% atypical squamous cell of undetermined significance, 64.62% low\u2010grade squamous intraepithelial lesion, 66.75% atypical squamous cell\u2010cannot exclude a high\u2010grade squamous intraepithelial lesion, and 91.80% HSIL. Furthermore, 29.09% of HSILs associated with other subtypes were not detectable on subsequent resections.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Given the HPV demographic distribution and the histological features of HSILs caused by different subtypes, cotesting with reflex HPV genotyping in specific populations, or expanding the subtypes in the primary HPV screening test, should be considered.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncy.22916","type":"journal-article","created":{"date-parts":[[2024,11,5]],"date-time":"2024-11-05T04:19:51Z","timestamp":1730780391000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Retrospective analysis of HPV infection: Cotesting and HPV genotyping in cervical cancer screening within a large academic health care 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Heersink School of Medicine University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3812-4098","authenticated-orcid":false,"given":"Michelle D.","family":"Reid","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Emory University Hospital Emory University School of Medicine  Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Hoskins","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Emory University Hospital Midtown Emory University School of Medicine  Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5093-785X","authenticated-orcid":false,"given":"Qun","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Emory University 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