{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T16:09:57Z","timestamp":1789574997145,"version":"build-2803163510"},"reference-count":31,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,2,8]],"date-time":"2025-02-08T00:00:00Z","timestamp":1738972800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl Journal of Cancer"],"published-print":{"date-parts":[[2025,7,15]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>As many countries are transitioning from cytology to human papillomavirus (HPV) testing as the primary cervical cancer screening test, we evaluated the impact of cumulative HPV screening during the implementation of HPV screening in the Norwegian cervical cancer screening programme (CervicalScreen Norway). Data from the second HPV screening round was compared with data from the first round. The second\u2010round analyses included only women who returned to routine screening 4\u20136\u2009years following a negative HPV test in the first round. Associations between screening rounds and HPV positivity, cytology results, and follow\u2010up recommendations were estimated by multinomial logistic regression, and relative risks of cervical intraepithelial neoplasia, grade 3 or worse (CIN3+) by Cox regression. There was a 42% lower risk of being HPV positive in the second screening round compared to the first (age\u2010adjusted relative risk ratio (aRRR) 0.58, 95% confidence interval (CI) 0.53 to 0.65), and a 70% lower risk of having high\u2010grade cytology among HPV16 positive women (0.30, 0.12 to 0.78). There was also a 51% reduction in referrals for immediate colposcopy (0.49, 0.39 to 0.62). The overall risk of CIN3+ was 71% lower in the second round compared to the first (age\u2010adjusted hazard ratio [aHR] 0.29, 95%CI 0.21\u20130.40), and lower among HPV16 and other high\u2010risk HPV positive women, but not among HPV18 positives. No cervical cancers were diagnosed in the second round (mean follow\u2010up 2.4\u2009years). Our findings indicate that HPV test results from previous screening rounds should be considered when designing optimal screening algorithms.<\/jats:p>","DOI":"10.1002\/ijc.35359","type":"journal-article","created":{"date-parts":[[2025,2,11]],"date-time":"2025-02-11T05:31:02Z","timestamp":1739251862000},"page":"251-259","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Risk of high\u2010grade cervical lesions in the second round of primary human papillomavirus testing in <scp>CervicalScreen<\/scp> Norway: A population\u2010based cohort study"],"prefix":"10.1002","volume":"157","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9096-5257","authenticated-orcid":false,"given":"Tone","family":"Bj\u00f8rge","sequence":"first","affiliation":[{"name":"Section for Cervical Cancer Screening, Cancer Registry of Norway Norwegian Institute of Public Health  Oslo Norway"},{"name":"Department of Global Public Health and Primary Care University of Bergen  Bergen Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathalie C.","family":"St\u00f8er","sequence":"additional","affiliation":[{"name":"Section for Cervical Cancer Screening, Cancer Registry of Norway Norwegian Institute of Public Health  Oslo Norway"},{"name":"Department of Research, Cancer Registry of Norway Norwegian Institute of Public Health  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara K.","family":"Hverven","sequence":"additional","affiliation":[{"name":"Section for Cervical Cancer Screening, Cancer Registry of Norway Norwegian Institute of Public Health  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mari","family":"Nyg\u00e5rd","sequence":"additional","affiliation":[{"name":"Department of Research, Cancer Registry of Norway Norwegian Institute of Public Health  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ameli","family":"Trop\u00e9","sequence":"additional","affiliation":[{"name":"Section for Cervical Cancer Screening, Cancer Registry of Norway Norwegian Institute of Public Health  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Birgit","family":"Enges\u00e6ter","sequence":"additional","affiliation":[{"name":"Section for Cervical Cancer Screening, Cancer Registry of Norway Norwegian Institute of Public Health  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,2,8]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"Council of the European Union.Council Recommendation on strengthening prevention through early detection: A new EU approach on cancer screening replacing Council Recommendation 2003\/878\/EC.2022https:\/\/data.consilium.europa.eu\/doc\/document\/ST-14770-2022-INIT\/en\/pdf"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2019.09.006"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21628"},{"key":"e_1_2_9_5_1","unstructured":"The Royal Australian and New Zealand College of Obstetricians and Gynaecologists Women's Health Committee.National Guidelines. 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