{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T00:18:00Z","timestamp":1785802680588,"version":"3.56.0"},"reference-count":32,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2020,3,26]],"date-time":"2020-03-26T00:00:00Z","timestamp":1585180800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100008363","name":"Kr\u00e6ftens Bek\u00e6mpelse","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008363","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl Journal of Cancer"],"published-print":{"date-parts":[[2020,9,15]]},"abstract":"<jats:p>Many countries are transitioning to HPV testing for cervical cancer screening, despite a lack of long\u2010term experience. To anticipate multi\u2010round screening performance, we analyzed 15\u2010year HPV testing results at Kaiser Permanente Northern California (KPNC). We evaluated HPV test result patterns among women aged 30\u201364 undergoing triennial HPV\/cytology cotesting at KPNC during 2003\u20132018. We calculated incidence rates and proportion of CIN3+ diagnoses associated with the most frequent HPV testing patterns overall and stratified by age. From 2003 to 2018, a total of 1,361,581 women had a valid HPV test result, and 7,087 were diagnosed with CIN3+. Incidence rates of CIN3+ after HPV positivity were lowest when HPV detection was new and highest in women with prevalent infections (770 <jats:italic>vs<\/jats:italic>. 13,910\/100,000 person\u2010years). Repeat test negativity reduced subsequent incidence rates of CIN3+ to extremely low levels (18\/100,000 person\u2010years following four consecutive negative results). For mixed patterns of positivity\/negativity, the recency and frequency of positive tests were associated with increased rates of CIN3+ diagnosis. Most CIN3+ cases (76%) were diagnosed in women who were positive at baseline (the first known positive HPV result); 16% were attributed to apparent newly detected infections and 3% to possible reappearing infections. These results corroborate previous findings that current HPV positivity, particularly when prevalent rather than new, is associated with the highest rates of CIN3+. In a screening program implementing HPV testing, most CIN3+ is detected at the first HPV positive test.<\/jats:p>","DOI":"10.1002\/ijc.32950","type":"journal-article","created":{"date-parts":[[2020,3,6]],"date-time":"2020-03-06T13:01:43Z","timestamp":1583499703000},"page":"1612-1620","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["A study of the risks of CIN3+ detection after multiple rounds of HPV testing: Results of the 15\u2010year cervical cancer screening experience at Kaiser Permanente Northern California"],"prefix":"10.1002","volume":"147","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4616-9827","authenticated-orcid":false,"given":"Anne","family":"Hammer","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Herning Hospital  Herning Denmark"},{"name":"Department of Clinical Medicine Aarhus University  Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Demarco","sequence":"additional","affiliation":[{"name":"Division of Cancer Epidemiology and Genetics, Clinical Genetics Branch National Cancer Institute  Bethesda MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0840-4339","authenticated-orcid":false,"given":"Nicole","family":"Campos","sequence":"additional","affiliation":[{"name":"Center for Health Decision Science, Department of Health Policy and Management Harvard T.H. Chan School of Public Health  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Befano","sequence":"additional","affiliation":[{"name":"Information Management Services Inc.  Calverton MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patti E.","family":"Gravitt","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Public Health University of Maryland School of Medicine  Baltimore MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Cheung","sequence":"additional","affiliation":[{"name":"Division of Cancer Epidemiology and Genetics, Clinical Genetics Branch National Cancer Institute  Bethesda MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas S.","family":"Lorey","sequence":"additional","affiliation":[{"name":"Regional Laboratory, Kaiser Permanente Northern California  Berkeley CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy","family":"Poitras","sequence":"additional","affiliation":[{"name":"Regional Laboratory, Kaiser Permanente Northern California  Berkeley CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walter","family":"Kinney","sequence":"additional","affiliation":[{"name":"Albert Einstein College of Medicine  Bronx NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1251-0836","authenticated-orcid":false,"given":"Nicolas","family":"Wentzensen","sequence":"additional","affiliation":[{"name":"Division of Cancer Epidemiology and Genetics, Clinical Genetics Branch National Cancer Institute  Bethesda MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip E.","family":"Castle","sequence":"additional","affiliation":[{"name":"Albert Einstein College of Medicine  Bronx NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Schiffman","sequence":"additional","affiliation":[{"name":"Division of Cancer Epidemiology and Genetics, Clinical Genetics Branch National Cancer Institute  Bethesda MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,3,26]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)62218-7"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.g130"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.30865"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.7326\/M17-1609"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djy192"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.32004"},{"key":"e_1_2_8_8_1","volume-title":"Agents Classified by the IARC Monographs, Vol. 1\u2013112","author":"IARC","year":"2015"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djq356"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djr283"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(11)70145-0"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djx225"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.00824-08"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.29143"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa073204"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1038\/bjc.2012.489"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djq001"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2016.10.042"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.31883"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1309\/AJCPTUS5EXAS6DKZ"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.30375"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2018.4270"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.currproblcancer.2018.06.007"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.27418"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.30454"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2018.7464"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1158\/0008-5472.CAN-12-2635"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.29959"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(10)70230-8"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1309\/AJCPGW1V2BBWMOCX"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2010.06.048"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000270154.69879.09"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2014.11.076"}],"container-title":["International Journal of Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fijc.32950","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ijc.32950","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ijc.32950","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ijc.32950","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,5]],"date-time":"2023-09-05T17:06:44Z","timestamp":1693933604000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ijc.32950"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,3,26]]},"references-count":32,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2020,9,15]]}},"alternative-id":["10.1002\/ijc.32950"],"URL":"https:\/\/doi.org\/10.1002\/ijc.32950","archive":["Portico"],"relation":{},"ISSN":["0020-7136","1097-0215"],"issn-type":[{"value":"0020-7136","type":"print"},{"value":"1097-0215","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,3,26]]},"assertion":[{"value":"2019-08-21","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-02-10","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-03-26","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}