{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,7]],"date-time":"2026-02-07T14:06:48Z","timestamp":1770473208334,"version":"3.49.0"},"reference-count":34,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2019,10,23]],"date-time":"2019-10-23T00:00:00Z","timestamp":1571788800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100008363","name":"Kr\u00e6ftens Bek\u00e6mpelse","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008363","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2020,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>The optimal clinical management of women diagnosed with low\u2010grade squamous intraepithelial lesions (LSIL) during cervical cancer screening remains unclear. In this prospective cohort study, we compared the clinical performance of two human papillomavirus (HPV) mRNA tests for triage of women with LSIL in Denmark.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>In a nationwide pathology register, we identified women aged 23\u201065\u00a0years with LSIL during 2008\u20102012. We included women tested for HPV mRNA with the PreTect HPV Proofer test for five high\u2010risk HPV types (n\u00a0=\u00a02176) or the Aptima assay for 14 high\u2010risk HPV types (n\u00a0=\u00a0426). Subsequent histological diagnoses of cervical intraepithelial neoplasia grades 2, 3 or cancer (CIN2+) were identified in the register. We calculated the sensitivity and specificity for CIN2+ at 18 and 36\u00a0months of follow up, and the cumulative incidence of CIN2+ among women testing positive and negative, overall and by age (23\u201029, 30\u201039, 40\u201065\u00a0years).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The proportion of women with a positive mRNA test at baseline was higher in women tested with Aptima (66.7%) than in women tested with Proofer (42.8%). After 18\u00a0months, Aptima had higher sensitivity for CIN2+ than Proofer  (98% [95% CI 94% to 100%] vs 85% [95% CI 82% to 88%]), whereas Proofer showed higher specificity than Aptima (67% [95% CI 64% to 70%]) vs (40% [95% CI 33% to 46%]). Aptima had particularly low specificity in women aged &lt;40\u00a0years (23\u201029: 19% [95% CI 5% to 36%]; 30\u201039: 10% [95% CI 0% to 33%]). The 36\u2010month cumulative incidence of CIN2+ was higher in Proofer positive (54.3% [95% CI 50.9% to 57.8%]) than in Aptima positive women (37.6% [95% CI 31.2% to 44.8%]). In women with a negative mRNA test, the 36\u2010month cumulative incidences of CIN2+ were 13.1% (95% CI 10.8% to 15.8%) and 5.9% (95% CI 1.7% to 19.0%) for Proofer and Aptima, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In women with LSIL, Aptima had high sensitivity for CIN2+, but low specificity, especially in women aged &lt;40\u00a0years. The Proofer test may be useful to limit immediate colposcopy referrals in younger women with LSIL, but given its low sensitivity and negative predictive value, Proofer negative women must be followed with repeat cytology.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.13741","type":"journal-article","created":{"date-parts":[[2019,9,28]],"date-time":"2019-09-28T19:20:55Z","timestamp":1569698455000},"page":"204-212","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Triage of low\u2010grade squamous intraepithelial lesions using human papillomavirus messenger ribonucleic acid tests\u2014A prospective population\u2010based register study"],"prefix":"10.1111","volume":"99","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4941-9665","authenticated-orcid":false,"given":"Kristian","family":"Reinholdt","sequence":"first","affiliation":[{"name":"Unit of Virus, Lifestyle, and Genes Danish Cancer Society Research Center Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kirsten E.","family":"Juul","sequence":"additional","affiliation":[{"name":"Unit of Virus, Lifestyle, and Genes Danish Cancer Society Research Center Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6161-4565","authenticated-orcid":false,"given":"Christian","family":"Dehlendorff","sequence":"additional","affiliation":[{"name":"Unit of Statistics and Pharmacoepidemiology Danish Cancer Society Research Center Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian","family":"Munk","sequence":"additional","affiliation":[{"name":"Unit of Virus, Lifestyle, and Genes Danish Cancer Society Research Center Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8347-1398","authenticated-orcid":false,"given":"Susanne K.","family":"Kj\u00e6r","sequence":"additional","affiliation":[{"name":"Unit of Virus, Lifestyle, and Genes Danish Cancer Society Research Center Copenhagen Denmark"},{"name":"Department of Gynecology Rigshospitalet University of Copenhagen Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0738-8410","authenticated-orcid":false,"given":"Louise T.","family":"Thomsen","sequence":"additional","affiliation":[{"name":"Unit of Virus, Lifestyle, and Genes Danish Cancer Society Research Center Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,10,23]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2013.04.024"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2006.06.018"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2012.06.095"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2014.12.022"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.3390\/v10120729"},{"key":"e_1_2_9_7_1","unstructured":"New Zealand Government.Ministry of Health. 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