{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T21:02:22Z","timestamp":1784926942156,"version":"3.55.0"},"reference-count":27,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2026,2,7]],"date-time":"2026-02-07T00:00:00Z","timestamp":1770422400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,2,7]],"date-time":"2026-02-07T00:00:00Z","timestamp":1770422400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl Journal of Cancer"],"published-print":{"date-parts":[[2026,6,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Women 30\u201359\u2009years were allocated to either HPV\u2010based screening or cytology\u2010based screening in this Danish health care policy trial. The optimal triage of HPV\u2010positive women could be a combination of cytology triage with HPV genotyping or p16\/Ki67 staining. We report number of screen positives, colposcopies, and cervical lesions of three different triage algorithms (p16\/Ki67, HPV16\/18, or HPV16\/18\/31\/33\/52) in HPV\u2010positive women with low\u2010grade cytological abnormalities. We included 178,317 women with a sample in 2021 of which 91,517 were screened with HPV and 86,800 with cytology. All women were followed for 18\u2009months. Almost three times as many women screened positive with HPV\u2010based screening compared to cytology\u2010based screening (RR 2.99, 95% 2.93\u20133.05) and colposcopies derived from the screening program were also more common (RR 1.68, 95% 1.63\u20131.73). p16\/Ki67 triage resulted in more colposcopies (RR 1.86, 95% 1.76\u20131.95) than HPV16\/18 (RR 1.54, 95% 1.44\u20131.65) and HPV16\/18\/31\/33\/52 (RR 1.63, 95% 1.55\u20131.71). The excess in colposcopy referrals was reduced when non\u2010screening\u2010derived colposcopies were included (intention\u2010to\u2010treat). Nevertheless, more women with CIN2 or worse were detected in the HPV group than in the cytology group per screened woman; in the p16\/Ki67 triage group (RR 1.65, 95% 1.54\u20131.77), in the HPV16\/18 group (RR 1.36, 95% 1.23\u20131.50), and in the HPV16\/18\/31\/33\/52 group (RR 1.48, 95% 1.37\u20131.59). HPV\u2010based screening, as compared with cytology screening, resulted in more screen positives, but all three triage algorithms substantially reduced the excess number of referrals to colposcopy. p16\/Ki67 compared to triage with HPV16\/18 may detect more cervical lesions.<\/jats:p>","DOI":"10.1002\/ijc.70365","type":"journal-article","created":{"date-parts":[[2026,2,7]],"date-time":"2026-02-07T13:17:02Z","timestamp":1770470222000},"page":"3197-3207","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Health care policy trial of primary human papillomavirus\u2013based cervical screening in Denmark: Comparison of three triage algorithms"],"prefix":"10.1002","volume":"158","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1776-0562","authenticated-orcid":false,"given":"Jeppe Bennekou","family":"Schroll","sequence":"first","affiliation":[{"name":"Cochrane Denmark &amp; Centre for Evidence\u2010Based Medicine Odense (CEBMO), Department of Clinical Research University of Southern Denmark  Odense Denmark"},{"name":"Open Patient Data Explorative Network (OPEN) Odense University Hospital  Odense Denmark"},{"name":"Department of Gynecology &amp; Obstetrics Herlev\u2010Gentofte Hospital  Herlev Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4853-6747","authenticated-orcid":false,"given":"Jesper","family":"Bonde","sequence":"additional","affiliation":[{"name":"Molecular Pathology Laboratory, Department of Pathology, afs. 134 AHH\u2010Hvidovre Hospital, Copenhagen University Hospital  Hvidovre Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4785-5236","authenticated-orcid":false,"given":"Elsebeth","family":"Lynge","sequence":"additional","affiliation":[{"name":"Department of Public Health University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianne","family":"Waldstr\u00f8m","sequence":"additional","affiliation":[{"name":"Department of Pathology Aarhus University Hospital  Aarhus Denmark"},{"name":"Department of Clinical Medicine Aarhus University  Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petra Hall","family":"Viborg","sequence":"additional","affiliation":[{"name":"The Danish Healthcare Quality Institute (DHQI) Rigshospitalet  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Frandsen","sequence":"additional","affiliation":[{"name":"Department of Pathology Aalborg University Hospital  \u00c5lborg Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rikke Holst","family":"Andersen","sequence":"additional","affiliation":[{"name":"Department of Pathology Region Hospital Randers  Randers Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanne Merete","family":"Nielsen","sequence":"additional","affiliation":[{"name":"Department of Pathology Region Zealand  N\u00e6stved Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bettina Kj\u00e6r","family":"Kristensen","sequence":"additional","affiliation":[{"name":"UNICCA, University Research Clinic for Cancer Screening, Department of Public Health Programmes Randers Regional Hospital  Randers Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doris","family":"Schledermann","sequence":"additional","affiliation":[{"name":"Department of Pathology Lille Baelt Hospital  Vejle Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Berit","family":"Andersen","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine Aarhus University  Aarhus Denmark"},{"name":"UNICCA, University Research Clinic for Cancer Screening, Department of Public Health Programmes Randers Regional Hospital  Randers Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the National Danish Cervical Cancer Screening Steering Committee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,2,7]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)62218-7"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1003748"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.EPI-22-0340"},{"issue":"9","key":"e_1_2_10_5_1","article-title":"Phased implementation of HPV\u2010based cervical cancer screening in Denmark","volume":"184","author":"Bonde J","year":"2022","journal-title":"Ugeskr Laeger"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcv.2020.104336"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1080\/14737159.2019.1613890"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.17248"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/LGT.0000000000000865"},{"key":"e_1_2_10_10_1","unstructured":"Dansk Kvalitetsdatabase for Livmoderhalskr\u00e6ftscreening. 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