{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T22:56:27Z","timestamp":1785452187615,"version":"3.56.0"},"reference-count":34,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2023,7,19]],"date-time":"2023-07-19T00:00:00Z","timestamp":1689724800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100008262","name":"Harboefonden","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100008262","id-type":"DOI","asserted-by":"publisher"}]},{"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":[[2023,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Many countries have adopted active surveillance in women with cervical intraepithelial neoplasia grade 2 (CIN2), leaving the lesion untreated. However, there is a lack of consensus on the eligibility criteria for active surveillance across countries, with some abstaining from active surveillance in women with human papilloma virus 16 (HPV16) or a high\u2010grade cytology. Here, we aimed to describe the distribution of HPV genotypes, age, and cytology in women undergoing active surveillance for CIN2.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>We conducted a single\u2010center cross\u2010sectional study on women aged 23\u201340 undergoing active surveillance for CIN2 during 2000\u20132010. Women were identified through the Danish Pathology Data Bank (DPDB) at Aarhus University Hospital, Denmark. We collected information on basic characteristics and results of histopathological examinations via DPDB. Women were deemed eligible for inclusion if they had a subsequent biopsy after index CIN2, and had no prior record of CIN2+, hysterectomy, or cone biopsy. Archived biopsies underwent HPV genotyping using the HPV SPF<jats:sub>10<\/jats:sub>\u2010 DEIA\u2010LiPA<jats:sub>25<\/jats:sub> system, and the diagnosis was re\u2010evaluated by three expert pathologists. We used the Chi squared\u2010test (<jats:italic>p<\/jats:italic>\u2010value) for comparison across groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We identified 3623 women with CIN2 of whom 455 (12.6%) were included. Most women were 30\u2009years or younger (73.8%), and half (48.8%) had a high\u2010grade index cytology. The prevalence of any high\u2010risk HPV was 87.0%, with HPV16 being the most prevalent genotype (35.6%). The prevalence of HPV16 was significantly higher in women aged 30 or younger (39.3%) compared to women older than 30\u2009years (25.2%) (<jats:italic>p<\/jats:italic>\u2009=\u20090.006). Upon expert review, 261 (57.4%) had CIN2 confirmed, whereas 56 (12.3%) were upgraded to CIN3 and 121 (26.6%) were downgraded to CIN1\/normal. While the HPV16 prevalence was similar between community and expert confirmed CIN2, the prevalence of HPV16 was significantly higher in women with expert CIN3 compared to women with expert CIN1\/normal (64.3% vs. 19.0%, <jats:italic>p<\/jats:italic>\u2009=\u20090.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The high prevalence of HPV16 and high\u2010grade cytology imply that these women may be perceived as a high\u2010risk population and non\u2010eligible for active surveillance in countries outside Denmark. Future studies should investigate the importance of HPV, age, cytology, and expert review on risk of progression to help refine criteria for active surveillance.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.14627","type":"journal-article","created":{"date-parts":[[2023,7,20]],"date-time":"2023-07-20T04:49:17Z","timestamp":1689828557000},"page":"1227-1235","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["High prevalence of <scp>HPV16<\/scp> and high\u2010grade cytology in women undergoing active surveillance for cervical intraepithelial neoplasia grade 2"],"prefix":"10.1111","volume":"102","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9400-662X","authenticated-orcid":false,"given":"Rikke Kamp","family":"Damgaard","sequence":"first","affiliation":[{"name":"Department of Clinical Medicine Aarhus University  Aarhus Denmark"},{"name":"Department of Obstetrics and Gynecology G\u00f8dstrup Hospital  Herning Denmark"},{"name":"NIDO Center for Research and Education G\u00f8dstrup Hospital  Herning Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Jenkins","sequence":"additional","affiliation":[{"name":"Viroclinics\u2010DDL (a Cerba Research Company), DDL Diagnostic Laboratory  Rijswijk The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark H.","family":"Stoler","sequence":"additional","affiliation":[{"name":"Department of Pathology University of Virginia  Charlottesville Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miekel M.","family":"van de Sandt","sequence":"additional","affiliation":[{"name":"Viroclinics\u2010DDL (a Cerba Research Company), DDL Diagnostic Laboratory  Rijswijk The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1657-8600","authenticated-orcid":false,"given":"Kathrine Dyhr","family":"Lycke","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine Aarhus University  Aarhus Denmark"},{"name":"Department of Obstetrics and Gynecology G\u00f8dstrup Hospital  Herning Denmark"},{"name":"NIDO Center for Research and Education G\u00f8dstrup Hospital  Herning Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurits N. C.","family":"de Koning","sequence":"additional","affiliation":[{"name":"Viroclinics\u2010DDL (a Cerba Research Company), DDL Diagnostic Laboratory  Rijswijk The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wim G. V.","family":"Quint","sequence":"additional","affiliation":[{"name":"Viroclinics\u2010DDL (a Cerba Research Company), DDL Diagnostic Laboratory  Rijswijk The Netherlands"},{"name":"Methylomics  Rijswijk The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Torben","family":"Steiniche","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine Aarhus University  Aarhus Denmark"},{"name":"Department of Pathology Aarhus University Hospital  Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lone Kjeld","family":"Petersen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Odense University Hospital  Odense Denmark"},{"name":"Department of Clinical Research University of Southern Denmark  Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4616-9827","authenticated-orcid":false,"given":"Anne","family":"Hammer","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine Aarhus University  Aarhus Denmark"},{"name":"Department of Obstetrics and Gynecology G\u00f8dstrup Hospital  Herning Denmark"},{"name":"NIDO Center for Research and Education G\u00f8dstrup Hospital  Herning Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,7,19]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000004705"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.k499"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/LGT.0000000000000604"},{"key":"e_1_2_12_5_1","article-title":"Obstetric outcomes after conservative treatment for cervical intraepithelial lesions and early invasive disease","volume":"11","author":"Kyrgiou M","year":"2017","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.i3633"},{"key":"e_1_2_12_7_1","unstructured":"Cervical cancer prevention in Sweden Kunskabsbanken cervical cancer prevention. 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