{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T13:55:52Z","timestamp":1780494952651,"version":"3.54.1"},"reference-count":50,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2019,10,6]],"date-time":"2019-10-06T00:00:00Z","timestamp":1570320000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl Journal of Cancer"],"published-print":{"date-parts":[[2020,5]]},"abstract":"<jats:p>The objective of our study was to assess the performance of different triage strategies for high\u2010risk human papillomavirus (hrHPV)\u2010positive results utilizing either extended genotyping or a p16\/Ki\u201067 dual\u2010stained cytology (DS) approach, with or without partial genotyping. A subset of women with hrHPV infections participating in the Addressing the Need for Advanced HPV Diagnostics (ATHENA) study were analyzed to determine the number of cervical intraepithelial neoplasia grade 3 or worse (\u2265CIN3) cases detected, and the absolute risk for \u2265CIN3 of each genotype. A clinical utility table was constructed to compare the impact of different triage strategies. In all, 2,339 women with single\u2010genotype hrHPV infections were identified. Among these were 171\u2009\u2265CIN3 cases. The U.S. Food and Drug Administration (FDA)\u2010approved algorithm (HPV16\/18 positive, or 12\u2010other hrHPV positive and Pap positive, i.e., \u2265 atypical squamous cells of undetermined significance) for primary HPV screening detected 132\/171 (77.2%)\u2009\u2265CIN3 cases and required 964 colposcopies (colposcopies per \u2265CIN3 ratio: 7.3). An approach that uses DS instead of cytology in the FDA\u2010approved algorithm detected 147\/171 (86.0%)\u2009\u2265CIN3 cases, requiring 1,012 colposcopies (ratio: 6.9). Utilizing DS for triage of all hrHPV\u2010positive women identified 126\/171 (73.7%)\u2009\u2265CIN3 cases, requiring 640 colposcopies (ratio: 5.1). A strategy that detected HPV16\/18\/31\/33\/35+ captured 130\/171 (76.0%)\u2009\u2265CIN3 cases, requiring 1,025 colposcopies (ratio: 7.9). Inclusion of additional genotypes resulted in greater disease detection at the expense of higher colposcopy ratios. Substituting cytology with a DS triage approach improved disease detection and the colposcopy detection rate. Further reduction of colposcopy rates can be achieved by using DS without partial genotyping. Extended genotyping strategies can identify a comparable number of cases but requires an increased number of colposcopies.<\/jats:p>","DOI":"10.1002\/ijc.32669","type":"journal-article","created":{"date-parts":[[2019,9,6]],"date-time":"2019-09-06T14:44:03Z","timestamp":1567781043000},"page":"2599-2607","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":37,"title":["Approaches to triage optimization in HPV primary screening: Extended genotyping and p16\/Ki\u201067 dual\u2010stained cytology\u2014Retrospective insights from ATHENA"],"prefix":"10.1002","volume":"146","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7738-7336","authenticated-orcid":false,"given":"Mark H.","family":"Stoler","sequence":"first","affiliation":[{"name":"Department of Pathology University of Virginia Health System  Charlottesville VA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ed","family":"Baker","sequence":"additional","affiliation":[{"name":"Roche Molecular Systems Inc.  Pleasanton CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean","family":"Boyle","sequence":"additional","affiliation":[{"name":"Roche Molecular Systems Inc.  Pleasanton CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shagufta","family":"Aslam","sequence":"additional","affiliation":[{"name":"Roche Molecular Systems Inc.  Pleasanton CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruediger","family":"Ridder","sequence":"additional","affiliation":[{"name":"Ventana Medical Systems, Inc. (Roche Tissue Diagnostics)  Tucson AZ"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Warner K.","family":"Huh","sequence":"additional","affiliation":[{"name":"Division of Gynecologic Oncology University of Alabama at Birmingham  Birmingham AL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr","given":"Thomas C.","family":"Wright","sequence":"additional","affiliation":[{"name":"Department of Pathology Columbia University  New York City NY"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,10,6]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2014.11.076"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)62218-7"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(11)70296-0"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ypmed.2016.11.029"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1309\/AJCPTGD94EVRSJCG"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000109426.82624.f8"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2018.10897"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2015.01.551"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1086\/657321"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12885-016-2961-2"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2018.04.007"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2011.07.024"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.26056"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/LGT.0b013e318285423c"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2014.12.022"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(10)70230-8"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.28605"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2011.02.033"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djv257"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2018.4270"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1155\/2007\/678793"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncy.20140"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.CCR-17-3251"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2012.05.004"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.29290"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncy.21542"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1038\/modpathol.2017.16"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncy.21807"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1038\/modpathol.2016.80"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncy.21800"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2019.0306"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1159\/000450595"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.30781"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2012.11.020"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.1309\/AJCPZ5JY6FCVNMOT"},{"key":"e_1_2_8_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(11)70188-7"},{"key":"e_1_2_8_38_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.03386-12"},{"key":"e_1_2_8_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2016.10.031"},{"key":"e_1_2_8_40_1","doi-asserted-by":"publisher","DOI":"10.1080\/10543400701668308"},{"key":"e_1_2_8_41_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0258(19981015)17:19<2207::AID-SIM920>3.0.CO;2-Y"},{"key":"e_1_2_8_42_1","doi-asserted-by":"publisher","DOI":"10.1200\/JGO.2016.006577"},{"key":"e_1_2_8_43_1","doi-asserted-by":"publisher","DOI":"10.1309\/AJCPTUS5EXAS6DKZ"},{"key":"e_1_2_8_44_1","doi-asserted-by":"publisher","DOI":"10.1038\/modpathol.2014.55"},{"key":"e_1_2_8_45_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pvr.2016.01.003"},{"key":"e_1_2_8_46_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.02116-14"},{"key":"e_1_2_8_47_1","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.EPI-14-1353"},{"key":"e_1_2_8_48_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pvr.2016.05.004"},{"key":"e_1_2_8_49_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djn510"},{"key":"e_1_2_8_50_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/dji187"},{"key":"e_1_2_8_51_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcv.2017.12.001"}],"container-title":["International Journal of Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fijc.32669","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ijc.32669","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ijc.32669","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ijc.32669","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,4]],"date-time":"2023-09-04T11:19:35Z","timestamp":1693826375000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ijc.32669"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,10,6]]},"references-count":50,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2020,5]]}},"alternative-id":["10.1002\/ijc.32669"],"URL":"https:\/\/doi.org\/10.1002\/ijc.32669","archive":["Portico"],"relation":{},"ISSN":["0020-7136","1097-0215"],"issn-type":[{"value":"0020-7136","type":"print"},{"value":"1097-0215","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,10,6]]},"assertion":[{"value":"2019-03-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-08-15","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-10-06","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}