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The intervention arm received baseline screening for high\u2010risk human papillomavirus (HPV) and the control arm received liquid\u2010based cytology (LBC) at baseline and 24 months. Both arms received 48\u2010month exit HPV and LBC cotesting. Exit results are presented for per\u2010protocol eligible (PPE) screened women. Participants were PPE at exit if they had completed all screening and recommended follow\u2010up and had not been diagnosed with cervical intraepithelial neoplasia Grade 2 or worse (CIN2+) earlier in the trial. Subgroups were identified based upon results at earlier trial screening. There were 9,457 and 9,552 and women aged 25\u201365 randomized to control and intervention and 7,448 (77.8%) and 8,281 (86.7%), respectively, were PPE and screened. Exit cotest results were similar (<jats:italic>p<\/jats:italic> = 0.11) by arm for PPE and the relative rate (RR) of CIN2+ for intervention <jats:italic>vs<\/jats:italic>. control was RR = 0.83 (95% CI: 0.56\u20131.23). The RR for CIN2+ comparing intervention women baseline HPV negative to control women with negative cytology at baseline and at 24\u2009months, was 0.68 (95% CI: 0.43\u20131.06). PPE women who had a negative or CIN1 colposcopy in earlier rounds had elevated rates (per 1,000) of CIN2+ at exit, control 31 (95% CI: 14\u201365) and intervention 43 (95% CI: 25\u201373). Among PPE women HPV negative at exit LBC cotesting identified little CIN2+, Rate = 0.3 (95% CI: 0.1\u20130.7). This per\u2010protocol analysis found that screening with HPV using a 4\u2010year interval is as safe as LBC with a 2\u2010year screening interval. LBC screening in HPV negative women at exit identified few additional lesions.<\/jats:p>","DOI":"10.1002\/ijc.32524","type":"journal-article","created":{"date-parts":[[2019,6,27]],"date-time":"2019-06-27T09:35:12Z","timestamp":1561628112000},"page":"1810-1818","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Disease detection at the 48\u2010month exit round of the HPV FOCAL cervical cancer screening trial in women per\u2010protocol eligible for routine screening"],"prefix":"10.1002","volume":"146","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3263-2649","authenticated-orcid":false,"given":"Andrew J.","family":"Coldman","sequence":"first","affiliation":[{"name":"Cancer Control Research, BC Cancer  Vancouver BC Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dirk","family":"van Niekerk","sequence":"additional","affiliation":[{"name":"Cervical Cancer Screening Program, BC Cancer  Vancouver BC Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mel","family":"Krajden","sequence":"additional","affiliation":[{"name":"BC Centre for Disease Control  Vancouver BC Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laurie W.","family":"Smith","sequence":"additional","affiliation":[{"name":"Cancer Control Research, BC Cancer  Vancouver BC Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1958-120X","authenticated-orcid":false,"given":"Darrel","family":"Cook","sequence":"additional","affiliation":[{"name":"BC Centre for Disease Control  Vancouver BC Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lovedeep","family":"Gondara","sequence":"additional","affiliation":[{"name":"Cancer Control Research, BC Cancer  Vancouver BC Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathy","family":"Ceballos","sequence":"additional","affiliation":[{"name":"Cervical Cancer Screening Program, BC Cancer  Vancouver BC Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David J.","family":"Quinlan","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of British Columbia  Vancouver BC Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marette","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of British Columbia  Vancouver BC Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruth","family":"Elwood\u2010Martin","sequence":"additional","affiliation":[{"name":"School of Public Health University of British Columbia  Vancouver BC Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Gentile","sequence":"additional","affiliation":[{"name":"Cervical Cancer Screening Program, BC Cancer  Vancouver BC Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stuart","family":"Peacock","sequence":"additional","affiliation":[{"name":"Canadian Centre for Applied Research in Cancer Control, BC Cancer  Vancouver BC Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gavin C.E.","family":"Stuart","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of British Columbia  Vancouver BC Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4409-8084","authenticated-orcid":false,"given":"Eduardo L.","family":"Franco","sequence":"additional","affiliation":[{"name":"Division of Cancer Epidemiology McGill University  Montreal QC Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5783-4493","authenticated-orcid":false,"given":"Gina S.","family":"Ogilvie","sequence":"additional","affiliation":[{"name":"Women's Health Research Institute  Vancouver BC Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,7,4]]},"reference":[{"key":"e_1_2_7_2_1","unstructured":"Health Council of the Netherlands. 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