{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T20:46:00Z","timestamp":1771274760289,"version":"3.50.1"},"reference-count":34,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2017,9,13]],"date-time":"2017-09-13T00:00:00Z","timestamp":1505260800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Danish Strategic Research Council","award":["10-092793"],"award-info":[{"award-number":["10-092793"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cytopathology"],"published-print":{"date-parts":[[2017,10]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>We studied how representative cytologically abnormal women (\u201creferral populations\u201d) are with respect to uncovering differences between human papillomavirus (<jats:styled-content style=\"fixed-case\">HPV<\/jats:styled-content>) assays in the primary screening where most women are cytologically normal.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 4997 women were tested with SurePath\u00ae cytology, and Hybrid Capture 2 (<jats:styled-content style=\"fixed-case\">HC<\/jats:styled-content>2), cobas, <jats:styled-content style=\"fixed-case\">CLART<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">APTIMA HPV<\/jats:styled-content> assays. Women with positive test results were offered a follow\u2010up. For all detected <jats:styled-content style=\"fixed-case\">HPV<\/jats:styled-content> infections and <jats:styled-content style=\"fixed-case\">HPV<\/jats:styled-content>\u2010positive high\u2010grade cervical intraepithelial neoplasia (\u2265<jats:styled-content style=\"fixed-case\">CIN<\/jats:styled-content>2), we studied the distributions of assay\u2010specific signal strengths in the baseline samples as documented by the assays\u2019 automatically generated reports. We calculated the likelihood of test result discordance as the proportion of <jats:styled-content style=\"fixed-case\">HPV<\/jats:styled-content>\u2010positive samples that were not confirmed by all four assays.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Median signal strengths for <jats:styled-content style=\"fixed-case\">HPV<\/jats:styled-content> infections were weaker in normal than abnormal cytology (<jats:italic>P<\/jats:italic>&lt;.001, adjusted for women's age, multiple infections and the reason for taking the sample). For <jats:styled-content style=\"fixed-case\">HC<\/jats:styled-content>2, they were <jats:styled-content style=\"fixed-case\">RLU<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">CO<\/jats:styled-content> 11.0 (interquartile range, <jats:styled-content style=\"fixed-case\">IQR<\/jats:styled-content>: 3.3\u201052.8) vs 124.2 (<jats:styled-content style=\"fixed-case\">IQR<\/jats:styled-content>: 22.8\u2010506.9), respectively; for cobas, Ct 33.5 (<jats:styled-content style=\"fixed-case\">IQR<\/jats:styled-content>: 29.6\u201037.5) vs 26.9 (<jats:styled-content style=\"fixed-case\">IQR<\/jats:styled-content>: 23.7\u201031.3), respectively; for <jats:styled-content style=\"fixed-case\">APTIMA<\/jats:styled-content>, S\/<jats:styled-content style=\"fixed-case\">CO<\/jats:styled-content> 10.2 (<jats:styled-content style=\"fixed-case\">IQR<\/jats:styled-content>: 5.8\u201011.3) vs 11.1 (<jats:styled-content style=\"fixed-case\">IQR<\/jats:styled-content>: 9.4\u201015.5), respectively. Similar patterns were observed for <jats:styled-content style=\"fixed-case\">HPV<\/jats:styled-content>\u2010positive \u2265<jats:styled-content style=\"fixed-case\">CIN<\/jats:styled-content>2. The four <jats:styled-content style=\"fixed-case\">HPV<\/jats:styled-content> assays more frequently returned discordant test results in normal than in abnormal cytology. Relative frequency of discordance in detecting <jats:styled-content style=\"fixed-case\">HPV<\/jats:styled-content> infections was 0.39 (95% confidence interval: 0.33\u20100.48) for abnormal vs normal cytology.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>These data suggest that referral population studies, by not including sufficient numbers of cytology normal women, underestimate the differences between <jats:styled-content style=\"fixed-case\">HPV<\/jats:styled-content> assays that would become apparent in primary screening.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cyt.12451","type":"journal-article","created":{"date-parts":[[2017,9,13]],"date-time":"2017-09-13T11:15:00Z","timestamp":1505301300000},"page":"419-428","source":"Crossref","is-referenced-by-count":10,"title":["Referral population studies underestimate differences between human papillomavirus assays in primary cervical 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Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Preisler","sequence":"additional","affiliation":[{"name":"Clinical Research Centre Copenhagen University Hospital Hvidovre Denmark"},{"name":"Department of Pathology Copenhagen University Hospital Hvidovre Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D.","family":"Ejegod","sequence":"additional","affiliation":[{"name":"Department of Pathology Copenhagen University Hospital Hvidovre Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C.","family":"Rygaard","sequence":"additional","affiliation":[{"name":"Department of Pathology Copenhagen University Hospital Hvidovre Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.","family":"Bonde","sequence":"additional","affiliation":[{"name":"Clinical Research Centre Copenhagen University Hospital Hvidovre Denmark"},{"name":"Department of Pathology Copenhagen University Hospital Hvidovre 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