{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T16:41:11Z","timestamp":1791650471373,"version":"4.3.4"},"reference-count":31,"publisher":"Oxford University Press (OUP)","issue":"2","funder":[{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["T32CA09168"],"award-info":[{"award-number":["T32CA09168"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["ZIACP101237-01"],"award-info":[{"award-number":["ZIACP101237-01"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"NIH","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,2,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>We demonstrated that cervical cancer risk following any screening result is lower if there is a known prior negative screening history vs an unknown screening history. We extended these findings to look at how screening performs following repeatedly negative screening results.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Approximately 1.7 million women aged 30-64\u2009years underwent triennial human papillomavirus (HPV) and cytology co-testing from 2003 to 2021. We modeled 5-year risks of cervical intraepithelial neoplasia grade 3 or more severe diagnoses (CIN3+) and invasive cervical cancer for the initial co-test, and then successive rounds following negative co-testing. A logistic-Weibull prevalence-incidence model was used to model risks.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>HPV test positivity was greater than cytology positivity for only the first co-test, and both positivity rates decreased with each screening round. Diagnostic yields of CIN3+ and cancer declined with each round of screening so the first screen yielded 8-fold more CIN3+ and invasive cancer than the fifth screen following 4 consecutive negative co-tests. Five-year risks of CIN3+ for positive and negative HPV and cytology results, individually or combined, decreased considerably after the first screen, with smaller decreases in each subsequent round. For cancer, we noticed a considerable decrease with the first screen only. Five-year CIN3+ risks were greater for positive HPV or cytology results, with a longer antecedent screening interval and younger age at screening (Ptrend\u2009&amp;lt;\u2009.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Triennial screening that includes HPV testing becomes inefficient after a single and more so after multiple negative screens. These data support the use of longer screening intervals, especially following negative screen(s).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jnci\/djaf317","type":"journal-article","created":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T13:09:59Z","timestamp":1761743399000},"page":"325-334","source":"Crossref","is-referenced-by-count":3,"title":["Impact of repeatedly screening negative on cervical cancer risk"],"prefix":"10.1093","volume":"118","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6408-5985","authenticated-orcid":false,"given":"Philip E","family":"Castle","sequence":"first","affiliation":[{"name":"Division of Cancer Prevention, US National Cancer Institute , Rockville, MD,","place":["United States"]},{"name":"Division of Cancer Epidemiology and Genetics, US National Cancer Institute , Rockville, MD,","place":["United 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