{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T05:37:43Z","timestamp":1791005863468,"version":"4.1.0"},"reference-count":22,"publisher":"BMJ","issue":"12","funder":[{"name":"Stockholm County Clinical Reseearch"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2017,10,31]]},"published-print":{"date-parts":[[2017,12]]},"abstract":"<jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To determine how human papillomavirus (HPV) positivity of atypical glandular cells (AGCs) affects the predictive values for the presence of high-grade cervical lesions.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>Population-based cohort study.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Setting<\/jats:title>\n                  <jats:p>Stockholm-Gotland region, Sweden.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Participants<\/jats:title>\n                  <jats:p>Between 17 February 2014 and 30 June 2016, there were 562 women with AGC detected in a cervical sample. Registry linkages up to 30 June 2016 identified 392 women with an associated HPV test and a histopathological follow-up.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Main outcome measure<\/jats:title>\n                  <jats:p>Presence of a high-grade cervical lesion in the cervical biopsy taken after the AGC smear, in relation to the HPV status of the AGC-containing index smear.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The proportion of HPV-positive AGC was 56% (n=222). In this group, there were six cases of invasive cervical adenocarcinoma, 33 cases of cervical adenocarcinoma in situ and 93 cases of high-grade squamous intraepithelial lesion (HSIL), giving a positive predictive value (PPV) for a cervical high-grade lesion of 60% (132\/222). Among the 170 women with HPV-negative AGC, there was one invasive cervical squamous cell cancer and four HSIL, giving an PPV for a cervical high-grade lesion of 2.9% (5\/170). This group also contained five endometrial cancers and one breast cancer.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>HPV triaging of AGC will greatly increase the predictive ability for identifying cervical high-grade lesions (OR: 48.4 (95% CI 19.1 to122.6)) and the high sensitivity (96%; 132\/137 women) implies safety of primary HPV screening strategies, with regard to this subset of patients. The measurable risk for endometrial cancer among women with HPV-negative AGC (2.9%) suggests that research on screening for endometrial cancer is needed.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjopen-2017-017070","type":"journal-article","created":{"date-parts":[[2017,12,14]],"date-time":"2017-12-14T23:49:19Z","timestamp":1513295359000},"page":"e017070","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":20,"title":["Risk of high-grade lesions after atypical glandular cells in cervical screening: a population-based cohort study"],"prefix":"10.1136","volume":"7","author":[{"given":"Ingrid","family":"Norman","sequence":"first","affiliation":[{"name":"Department of Clinical Pathology and Cytology, Karolinska University Laboratory, Karolinska University Hospital, Stockholm, Sweden"},{"name":"Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anders","family":"Hjerpe","sequence":"additional","affiliation":[{"name":"Department of Clinical Pathology and Cytology, Karolinska University Laboratory, Karolinska University Hospital, Stockholm, Sweden"},{"name":"Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joakim","family":"Dillner","sequence":"additional","affiliation":[{"name":"Department of Clinical Pathology and Cytology, Karolinska University Laboratory, Karolinska University Hospital, Stockholm, Sweden"},{"name":"Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2017,12,14]]},"reference":[{"key":"2025101811324791000_7.12.e017070.1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.20877"},{"key":"2025101811324791000_7.12.e017070.2","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1586\/eog.11.74","article-title":"Diagnostic and therapeutic challenges in the management of glandular abnormalities of the cervix","volume":"7","author":"Sarian","year":"2012","journal-title":"Expert Rev Obstet Gynecol"},{"key":"2025101811324791000_7.12.e017070.3","doi-asserted-by":"publisher","DOI":"10.1023\/A:1012761717028"},{"key":"2025101811324791000_7.12.e017070.4","doi-asserted-by":"publisher","DOI":"10.1006\/gyno.2000.5826"},{"key":"2025101811324791000_7.12.e017070.5","first-page":"1199","article-title":"Endocervical columnar cell intraepithelial neoplasia. 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