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This study aimed to evaluate the performance of an HPV integration test for the triage of HPV\u2010positive women.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>An observational cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>A cervical cancer screening programme in China.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>1393 HPV\u2010positive women aged 25\u201365\u2009years undergoing routine cervical cancer screening and HPV integration testing with 1\u2010year follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The sensitivity, specificity, positive predictive value and negative predictive value between HPV integration and cytology were compared.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Cervical intraepithelial neoplasia grade 3 or more severe (CIN3+).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 1393 HPV\u2010positive patients, 138 (9.9% [8.3\u201311.5%]) were HPV integration test positive compared with 537 who had abnormal cervical cytology (38.5% [36.0\u201341.1%]). Compared with cytology, HPV integration exhibited higher specificity (94.5% [93.3\u201395.8%] versus 63.8% [61.2\u201366.4%]) and equivalent sensitivity (70.5% [61.4\u201379.7%] versus 70.5% [61.4\u201379.7%]) for detection of CIN3+. HPV integration\u2010negative women accounted for 90.1% (1255\/1393) of the total population and had a low immediate CIN3+ risk (2.2%). At 1\u2010year follow\u2010up, the progression rate in the HPV integration\u2010positive women was higher than in the HPV integration\u2010negative women (12.0% versus 2.1%, odds ratio 5.6, 95% CI, 2.6\u201311.9). In 10 conservatively managed integration\u2010negative CIN2 patients, all showed spontaneous regression and seven showed HPV clearance after 1\u2010year follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The HPV integration test may be a precise risk stratification tool for HPV\u2010positive women and could avoid excessive use of invasive biopsies.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.17597","type":"journal-article","created":{"date-parts":[[2023,7,6]],"date-time":"2023-07-06T07:43:52Z","timestamp":1688629432000},"page":"309-318","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Testing for viral DNA integration among HPV\u2010positive women to detect cervical precancer: An observational cohort study"],"prefix":"10.1111","volume":"131","author":[{"given":"Ting","family":"Hu","sequence":"first","affiliation":[{"name":"Department of Gynaecological Oncology, Tongji 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KDWS Biological Technology Co., Ltd New Technology Platform  Wuhan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6789-5185","authenticated-orcid":false,"given":"Hui","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Gynaecologic Oncology, Women's Hospital, School of Medicine Zhejiang University  Zhejiang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ding","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Gynaecological Oncology, Tongji Hospital, Tongji Medical College Huazhong University of Science and Technology  Wuhan China"},{"name":"National Clinical Research Centre for Obstetrics and Gynaecology, Cancer Biology Research Centre (Key Laboratory of the Ministry of Education), Tongji Hospital, Tongji Medical College Huazhong University of Science and Technology  Wuhan 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