{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T10:58:22Z","timestamp":1786618702082,"version":"build-2736575974"},"reference-count":38,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T00:00:00Z","timestamp":1770336000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>HPV DNA\u2013positive women with ASC-US\/LSIL cytology represent a heterogeneous risk group in cervical screening and require efficient triage. We evaluated a genotype-specific 7-type HPV E6\/E7 mRNA assay (PreTect HPV-Proofer 7; types 16\/18\/31\/33\/45\/52\/58) in a real-world quality-assurance cohort at Nordland Hospital (Bod\u00f8, Norway). Among HPV-positive women with ASC-US\/LSIL reflex cytology, 225 had sufficient residual liquid-based cytology material and a valid mRNA result; 175 had complete follow-up (2022\u20132025) and were included. Overall, 44.6% (78\/175) were mRNA-positive (ASC-US 45.2%; LSIL 43.3%). For CIN2+, sensitivity was 63.4%, specificity 61.2%, PPV 33.3%, and NPV 84.5%; CIN2+ risk was 33.3% in mRNA-positive versus 15.5% in mRNA-negative women (RR 2.16, 95% CI 1.23\u20133.78). For CIN3+, risk was 14.1% versus 6.2%. Genotype-specific PPVs were highest for HPV33, HPV18, HPV16, and HPV31. In a referral simulation, mRNA-guided triage reduced baseline colposcopy referrals by 55% and decreased colposcopies per detected CIN2+ by ~30%, while 15 CIN2+ and 6 CIN3+ occurred in the mRNA-negative group and would be expected to be detected at 12-month follow-up among women with persistent HPV positivity. Genotype-aware HPV E6\/E7 mRNA triage improves risk stratification and may increase screening efficiency.<\/jats:p>","DOI":"10.3390\/pathogens15020178","type":"journal-article","created":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T10:05:47Z","timestamp":1770372347000},"page":"178","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Genotype-Specific HPV E6\/E7 mRNA Triage Improves Risk Stratification and Reduces Referrals in DNA-Positive ASC-US\/LSIL: A Real-World Cohort from Nordland, Norway"],"prefix":"10.3390","volume":"15","author":[{"given":"Khalid","family":"Al-Shibli","sequence":"first","affiliation":[{"name":"Department of Pathology, Nordlandssykehuset HF, 8092 Bod\u00f8, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dat Tan","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Department of Pathology, Nordlandssykehuset HF, 8092 Bod\u00f8, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiba Abdul Latif","family":"Mohammed","sequence":"additional","affiliation":[{"name":"Department of Gynecology, Nordlandssykehuset HF, 8092 Bod\u00f8, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8250-3992","authenticated-orcid":false,"given":"Sveinung Wergeland","family":"S\u00f8rbye","sequence":"additional","affiliation":[{"name":"Department of Clinical Pathology, University Hospital of North Norway, 9019 Troms\u00f8, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,6]]},"reference":[{"key":"ref_1","unstructured":"IARC Working Group on the Evaluation of Cancer-Preventive Interventions (2025, October 26). 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