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We compared the efficacy of high-risk human papillomavirus (HR-HPV) detection, cytology, and their combination in routine clinical practice after the implementation of the training and QC program to identify the optimal first-line screening method in this region.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>The data of patients histologically diagnosed with cervical intraepithelial neoplasia (CIN) 1, CIN2\/3, and invasive cervical cancer (ICC) between January 2014 and December 2017 were retrieved from the JKD database. Cytology and\/or HR-HPV testing results within 3\u2009months preceding the CIN1 diagnoses and 6\u2009months preceding the CIN2\/3 and ICC diagnoses were analyzed.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Prior screening data were available for 1829 CIN1 patients, 2309 CIN2\/3 patients, and 680 ICC patients. Cytology alone and HR-HPV testing alone had similar rates of positive results for CIN2\/3 (97.2% [854\/879] vs. 95.4% [864\/906], <jats:italic>P<\/jats:italic>\u2009=\u20090.105) and ICC detection (89.1% [205\/230] vs. 92.7% [204\/220], <jats:italic>P<\/jats:italic>\u2009=\u20090.185). Compared with either method alone, co-testing slightly increased the screening sensitivity for CIN2\/3 (99.8% [523\/524], all <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001) and ICC (99.6% [229\/230], all <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001) detection. In the CIN1 group, cervical cytology alone (92.9% [520\/560]) was more sensitive than HR-HPV testing alone (79.9% [570\/713], <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001), and co-testing (95.3% [530\/556]) did not significantly improve the screening sensitivity (<jats:italic>P<\/jats:italic>\u2009=\u20090.105).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>After the implementation of a systematic training and QC program, both cytology and HR-HPV testing may be adopted for primary cervical cancer screening in Shandong Province.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12885-020-07321-2","type":"journal-article","created":{"date-parts":[[2020,8,26]],"date-time":"2020-08-26T04:12:03Z","timestamp":1598415123000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Outcomes of prior cervical cytology and HR-HPV testing in women subsequently diagnosed with CIN1, CIN2\/3, and invasive cervical cancer: a 4-year routine clinical experience after implementation of systematic training and quality control programs"],"prefix":"10.1186","volume":"20","author":[{"given":"Dongman","family":"Zhao","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liran","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fengxiang","family":"Xie","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dezhi","family":"Peng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jie","family":"Wei","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lingbo","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shoudu","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Debo","family":"Qi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2020,8,26]]},"reference":[{"issue":"12","key":"7321_CR1","doi-asserted-by":"crossref","first-page":"2893","DOI":"10.1002\/ijc.25516","volume":"127","author":"J Ferlay","year":"2010","unstructured":"Ferlay J, Shin HR, Bray F, Forman D, Mathers C, Parkin DM. 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Int J Cancer. 2013;132(9):2141\u20137.","journal-title":"Int J Cancer"}],"container-title":["BMC Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12885-020-07321-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12885-020-07321-2\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12885-020-07321-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,4,17]],"date-time":"2022-04-17T21:10:14Z","timestamp":1650229814000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmccancer.biomedcentral.com\/articles\/10.1186\/s12885-020-07321-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,8,26]]},"references-count":47,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2020,12]]}},"alternative-id":["7321"],"URL":"https:\/\/doi.org\/10.1186\/s12885-020-07321-2","relation":{},"ISSN":["1471-2407"],"issn-type":[{"value":"1471-2407","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,8,26]]},"assertion":[{"value":"7 February 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 August 2020","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 August 2020","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"This study was approved by the ethics review board of KingMed Diagnostics. Because the present study was an analysis of anonymous data, the ethics review board waived the need for patient consent. The patient data in this study were processed and published in strict accordance with the tenets of the Declaration of Helsinki, including the confidentiality and anonymity requirements.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"None declared.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"810"}}