{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:45:28Z","timestamp":1786977928858,"version":"build-2736575974"},"reference-count":26,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2021,11,5]],"date-time":"2021-11-05T00:00:00Z","timestamp":1636070400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl Journal of Cancer"],"published-print":{"date-parts":[[2022,3,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>How to manage human papillomavirus (HPV)\u2010positive women in cervical cancer screening remains debated. Our study compared different strategies to triage HPV positivity in a large cohort of women participating in a population HPV\u2010based screening program. Women were tested for HPV (Cobas 4800; Roche), and those positive were triaged with cytology; cytology\u2010positives were referred to colposcopy, while negatives were referred to 1\u2010year HPV retesting. All HPV\u2010positive women were also evaluated with p16\/ki67 dual staining (Roche). All lesions found within 24\u2009months of follow\u2010up were included in the analyses. Of the 70\u2009146 women tested, 4757 (6.8%) were HPV\u2010positive. Of these, 1090 were cytology\u2010positive and were referred to colposcopy. Of the 2958 HPV\u2010positive\/cytology\u2010negative women who presented at 1\u2010year retesting, 1752 (59.9%) still tested positive. Cumulatively, 532 CIN2+ (including 294 CIN3+) were found. The sensitivity of cytology, HPV16\/18 and p16\/ki67 as triage test for CIN3+ was 67.9%, 56.0% and 85.0%, respectively. The positive predictive value (PPV) for immediate colposcopy referral was 21.0%, 15.8% and 22.9%, respectively. Combining cytology with typing increased sensitivity to 83.9% and lowered PPV to 14.8%, while combining p16\/ki67 and typing increased sensitivity to 91.1%, lowering the PPV to 15.9%. Women negative to p16\/ki67 triage presented a cumulative 1\u2010year CIN3+ risk of about 1%. In conclusion, when triaging HPV positivity, p16\/ki67 performed better than cytology with or without HPV16\/18 genotyping. The strategies that included dual staining achieved sensitivity and low 1\u2010year risk for CIN3+ sufficiently high enough to permit considering extending the surveillance interval to 2 to 3\u2009years for HPV\u2010positive\/triage\u2010negative women.<\/jats:p>","DOI":"10.1002\/ijc.33858","type":"journal-article","created":{"date-parts":[[2021,10,27]],"date-time":"2021-10-27T13:13:27Z","timestamp":1635340407000},"page":"952-960","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Accuracy of different triage strategies for human papillomavirus positivity in an Italian screening population"],"prefix":"10.1002","volume":"150","author":[{"given":"Daniela","family":"Gustinucci","sequence":"first","affiliation":[{"name":"Laboratorio Unico di Screening, USL Umbria 1  Perugia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Benevolo","sequence":"additional","affiliation":[{"name":"IRCCS\u2014Regina Elena National Cancer Institute  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Cesarini","sequence":"additional","affiliation":[{"name":"Laboratorio Unico di Screening, USL Umbria 1  Perugia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1609-2440","authenticated-orcid":false,"given":"Pamela","family":"Mancuso","sequence":"additional","affiliation":[{"name":"Epidemiology Unit, Azienda Unit\u00e0 Sanitaria Locale\u2014IRCCS di Reggio Emilia  Reggio Emilia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Basilio","family":"Passamonti","sequence":"additional","affiliation":[{"name":"Laboratorio Unico di Screening, USL Umbria 1  Perugia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Donata","family":"Giaimo","sequence":"additional","affiliation":[{"name":"Screening Oncologici, USL Umbria 1  Perugia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosa","family":"Corvetti","sequence":"additional","affiliation":[{"name":"Screening Oncologici, USL Umbria 2  Terni Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valeria","family":"Nofrini","sequence":"additional","affiliation":[{"name":"Laboratorio Unico di Screening, USL Umbria 1  Perugia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simonetta","family":"Bulletti","sequence":"additional","affiliation":[{"name":"Laboratorio Unico di Screening, USL Umbria 1  Perugia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morena","family":"Malaspina","sequence":"additional","affiliation":[{"name":"Laboratorio Unico di Screening, USL Umbria 1  Perugia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beatrice","family":"Tintori","sequence":"additional","affiliation":[{"name":"Laboratorio Unico di Screening, USL Umbria 1  Perugia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9703-2460","authenticated-orcid":false,"given":"Paolo","family":"Giorgi Rossi","sequence":"additional","affiliation":[{"name":"Epidemiology Unit, Azienda Unit\u00e0 Sanitaria Locale\u2014IRCCS di Reggio Emilia  Reggio Emilia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the Umbria HPV Screening Working Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,11,5]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"WHO Guidelines for Screening and Treatment of Precancerous Lesions for Cervical Cancer Prevention. 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