{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T23:26:28Z","timestamp":1771629988423,"version":"3.50.1"},"reference-count":19,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T00:00:00Z","timestamp":1765324800000},"content-version":"vor","delay-in-days":9,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100007192","name":"Rijksinstituut voor Volksgezondheid en Milieu","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100007192","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Medical Virology"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>High\u2010risk human papillomavirus (hrHPV)\u2010genotype specific risk stratification may improve cervical screening efficiency. This study evaluates the risks of cervical intraepithelial neoplasia (CIN), cancer and unnecessary referrals by hrHPV\u2010genotype in cytology\u2010positive (ASCUS+) women, using data from the Dutch population\u2010based cervical screening program. Data from hrHPV+\/ASCUS+ women screened between January 2017 and March 2018 were analyzed using the Dutch Screening and Pathology databases. Risks for CIN2+\/3+, cancer, and unnecessary referral (i.e., without CIN2+) were evaluated by hrHPV\u2010genotype (HPV16, HPV18, hrHPV\u2010other (i.e., non\u201016\/18 hrHPV), or mixed HPV16\/18) using logistic regression, adjusted for age, laboratory (as proxy for region), sampling method (self\u2010 vs. clinician sampling), and stratified by age (&lt;\u200950\/\u2265\u200950 years). HPV16+ women had 3.7 (CI: 3.42\u20133.95) and 4.6 (CI: 4.24\u20134.99) times higher risks of CIN2+ and CIN3+, respectively, compared to hrHPV\u2010other. HPV18+ women had 1.6 (CI: 1.43\u20131.79) and 1.9 (CI: 1.68\u20132.18) times higher risks. The cervical cancer risk was tenfold higher for both HPV16 (OR: 9.85, CI: 6.50\u201314.95) and HPV18 (OR: 10.27, CI: 6.33\u201316.68). Women with HPV16 had 70% and HPV18 40% lower risks of unnecessary referral, compared to hrHPV\u2010other. All risk differences between HPV16 or HPV18 and hrHPV\u2010other were statistically significant in both age groups (&lt;\u200950 and \u2265\u200950 years). Given the significantly higher risk of CIN2+\/3+ and cancer associated with HPV16 and HPV18 and the reduced likelihood of unnecessary referrals compared to hrHPV other, these findings support the use of genotype\u2010based colposcopy referrals in cervical screening to enhance screening efficiency.<\/jats:p>","DOI":"10.1002\/jmv.70745","type":"journal-article","created":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T08:55:13Z","timestamp":1765356913000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Improving Efficiency in Dutch Cervical Screening by Genotyping: An Analysis of Real World Program Data"],"prefix":"10.1002","volume":"97","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5549-6216","authenticated-orcid":false,"given":"Ellen M. 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