{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T14:06:25Z","timestamp":1787321185802,"version":"build-2736575974"},"reference-count":35,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T00:00:00Z","timestamp":1782518400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T00:00:00Z","timestamp":1782518400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100000245","name":"Michael Smith Health Research BC","doi-asserted-by":"publisher","award":["RT\u20102021\u20101595"],"award-info":[{"award-number":["RT\u20102021\u20101595"]}],"id":[{"id":"10.13039\/501100000245","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01 CA221918"],"award-info":[{"award-number":["R01 CA221918"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["MCT82072"],"award-info":[{"award-number":["MCT82072"]}],"id":[{"id":"10.13039\/501100000024","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":[[2026,10,15]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Evidence on the comparative effectiveness of HPV testing versus cytology specifically in women aged \u2265\u200950\u2009years who are approaching screening cessation remains limited. This analysis included 6471 women aged \u2265\u200950 at baseline screening in the HPV FOCAL randomized clinical trial. Women were randomly allocated to receive cytology (Control Group,\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u20093248, 50.19%) or HPV testing (Intervention Group,\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u20093223, 49.81%) at baseline, with co\u2010testing at 48\u2010month exit. We calculated incidence rates and risk ratios for CIN2+ detection over follow\u2010up and compared missed lesions at exit by screening method. At the 48\u2010month exit, CIN2+ detection was lower among HPV baseline\u2010negative women than among those in the cytology group (1.61\/1000 [95% CI, 0.52\u20133.76] vs. 3.15\/1000 [95% CI, 1.51\u20135.78]; risk ratio, 0.51 [95% CI, 0.11\u20130.91]), reflecting higher baseline detection with HPV testing and fewer prevalent lesions at exit. Even with cytology re\u2010screening at 2\u2009years, 50% of CIN2+ cases were missed compared to 30% with HPV testing. After adjusting for age, education, smoking status, and lifetime sexual partners, the hazard ratio for CIN2+ comparing HPV to cytology was 0.44 (95% CI, 0.22\u20130.88). Among women aged \u2265\u200950\u2009years, HPV primary screening was more effective than cytology at detecting CIN2+ lesions and was associated with a continued lower subsequent risk following a negative HPV test, supporting its use in cervical cancer screening programs in this age cohort.\n                  <\/jats:p>","DOI":"10.1002\/ijc.70616","type":"journal-article","created":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T10:03:25Z","timestamp":1782554605000},"page":"2066-2074","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["<scp>HPV<\/scp>\n                    Testing Versus Cytology for Cervical Cancer Screening\u00a0Among Women 50\u2009Years and Older: Evidence From the\n                    <scp>HPV FOCAL<\/scp>\n                    Randomized Controlled Trial"],"prefix":"10.1002","volume":"159","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5119-2394","authenticated-orcid":false,"given":"Md Saiful","family":"Alam","sequence":"first","affiliation":[{"name":"University of British Columbia  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurie W.","family":"Smith","sequence":"additional","affiliation":[{"name":"Women's Health Research Institute BC Women's Hospital and Health Service  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lovedeep","family":"Gondara","sequence":"additional","affiliation":[{"name":"University of British Columbia  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1958-120X","authenticated-orcid":false,"given":"Darrel","family":"Cook","sequence":"additional","affiliation":[{"name":"British Columbia Centre for Disease Control  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruth Elwood","family":"Martin","sequence":"additional","affiliation":[{"name":"University of British Columbia  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8243-8721","authenticated-orcid":false,"given":"Stuart","family":"Peacock","sequence":"additional","affiliation":[{"name":"Population Health Sciences BC Cancer  Vancouver British Columbia Canada"},{"name":"Faculty of Health Sciences Simon Fraser University  Burnaby British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lily","family":"Proctor","sequence":"additional","affiliation":[{"name":"University of British Columbia  Vancouver British Columbia Canada"},{"name":"Cervical Screening Program British Columbia Cancer  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gavin","family":"Stuart","sequence":"additional","affiliation":[{"name":"University of British Columbia  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Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3095-2323","authenticated-orcid":false,"given":"Anna","family":"Gottschlich","sequence":"additional","affiliation":[{"name":"Department of Oncology, Karmanos Cancer Institute Wayne State School of Medicine  Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5783-4493","authenticated-orcid":false,"given":"Gina S.","family":"Ogilvie","sequence":"additional","affiliation":[{"name":"University of British Columbia  Vancouver British Columbia Canada"},{"name":"Women's Health Research Institute BC Women's Hospital and Health Service  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,27]]},"reference":[{"key":"e_1_2_13_2_1","volume-title":"Global Strategy to Accelerate the Elimination of Cervical Cancer as a Public Health Problem 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