{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T17:41:30Z","timestamp":1791222090093,"version":"4.1.0"},"reference-count":36,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2021,3,14]],"date-time":"2021-03-14T00:00:00Z","timestamp":1615680000000},"content-version":"vor","delay-in-days":13,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100003554","name":"Lundbeckfonden","doi-asserted-by":"publisher","award":["R287\u20102018\u20101454"],"award-info":[{"award-number":["R287\u20102018\u20101454"]}],"id":[{"id":"10.13039\/501100003554","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":[[2021,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Human papillomavirus (HPV) testing as the primary cervical cancer screening method is implemented in several countries. We report data from the first round of a large Danish pilot implementation of HPV\u2010based screening. Our aim was to compare colposcopy referrals, detection of high\u2010grade cervical intraepithelial neoplasia (CIN) and cervical cancer, and positive predictive value (PPV) of colposcopy referral in HPV vs cytology\u2010based screening.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>From May 2017 to October 2018, women aged 30\u201059\u00a0years attending cervical cancer screening in the uptake area of the Department of Pathology, Vejle Hospital, Region of Southern Denmark were screened by primary HPV testing (n\u00a0=\u00a016\u00a0067) or primary cytology (n\u00a0=\u00a023\u00a0981) depending on municipality of residence. In the HPV group, women with HPV16\/18, or other high\u2010risk HPV types and abnormal cytology, were referred to immediate colposcopy. Women with other high\u2010risk HPV types and normal cytology were invited for repeat screening with HPV test and cytology after 12\u00a0months. From a nationwide pathology register, we obtained information on screening results and subsequent histological diagnoses during up to 2.9\u00a0years after the first screen. PPVs included diagnoses within 1 year after referral.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In the HPV group, 3.7% were referred to immediate colposcopy and 2.8% were referred at the 12\u2010month repeat screening. The total referral to colposcopy was higher in the HPV (6.6%) than cytology group (2.1%) (age\u2010adjusted relative referral\u00a0=\u00a03.05, 95% confidence interval [CI] 2.75\u20103.38). The detection of CIN3+ was higher in the HPV (1.5%) than the cytology group (0.8%) (age\u2010adjusted relative detection\u00a0=\u00a01.88, 95% CI 1.56\u20102.28). The probability of CIN3<jats:sup>+<\/jats:sup> among women referred to colposcopy (=\u00a0PPV) was lower in the HPV (21.1%; 95% CI 18.7%\u201023.7%) than the cytology group (34.6%; 95% CI 30.7%\u201038.9%). In the HPV group, the PPV was lower among women referred at repeat screening (12.1%) than among women referred immediately (27.8%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Compared with cytology\u2010based screening, HPV\u2010based screening provided a 90% increased CIN3+ detection at the cost of a threefold increase in colposcopy referrals, when considering complete data from the prevalence round. Our findings support implementation of HPV\u2010based screening in Denmark, but modifications of screening algorithms may be warranted to decrease unnecessary colposcopy referrals.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.14121","type":"journal-article","created":{"date-parts":[[2021,2,10]],"date-time":"2021-02-10T13:57:26Z","timestamp":1612965446000},"page":"394-402","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":34,"title":["Benefits and potential harms of human papillomavirus (HPV)\u2010based cervical cancer screening: A real\u2010world comparison of HPV testing versus cytology"],"prefix":"10.1111","volume":"100","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0738-8410","authenticated-orcid":false,"given":"Louise T.","family":"Thomsen","sequence":"first","affiliation":[{"name":"Unit of Virus, Lifestyle and Genes Danish Cancer Society Research Center Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"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 Copenhagen University Hospital Rigshospitalet Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Munk","sequence":"additional","affiliation":[{"name":"Unit of Virus, Lifestyle and Genes Danish Cancer Society Research Center Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorthe","family":"\u00d8rnskov","sequence":"additional","affiliation":[{"name":"Department of Pathology Vejle Hospital Lillebaelt Hospital Region of Southern Denmark Vejle Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianne","family":"Waldstr\u00f8m","sequence":"additional","affiliation":[{"name":"Department of Pathology Vejle Hospital Lillebaelt Hospital Region of Southern Denmark Vejle Denmark"},{"name":"Institute of Regional Health Research University of Southern Denmark Odense 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