Five-year risk of CIN3 after short-term HPV-DNA negativity in cytology-negative women: a population-based cohort study

A. Del Mistro, P. Giorgi Rossi, H. Frayle, L. Pasquale, C. Campari, G. Ronco, M. Zorzi

Research output: Contribution to journalArticlepeer-review


Objective: To assess the 5-year risk of high-grade lesions in women with a transient high-risk HPV infection. Design: Population-based cohort study. Setting: HPV primary testing within population-based organised cervical cancer screening programmes. Population: Italian women enrolled in seven pilot projects and attending the second round. Methods: On the basis of the cytology triage performed on HPV-positive women, immediate colposcopy or HPV repeat at 12 months was recommended. Data were collected at the subsequent round 3–4 years after HPV infection clearance. Main outcome measures: Rates of HPV infection, CIN2+ and CIN3+ detection at subsequent round after HPV clearance, and relative risks (RR) in comparison with HPV-negative women (with 95% confidence interval). Results: Data on 1230 women (1027 aged 25–64 years and 203 aged 35–64 years) have been analysed. Overall compliance with repeat HPV testing was 84%. In comparison with HPV-negative women, those with a transient HPV infection had higher proportions of HPV positivity (15% versus 3.7%) and of CIN2+ lesions (0.87% versus 0.23%) in round two; most of these (7/10) were CIN2; no cancers were detected, and CIN3 occurred in 3/1230 (0.24%). Conclusions: HPV-based protocols for cervical cancer screening allow long intervals for HPV-negative women; it is important to monitor the clinical outcome in the women with transient high-risk HPV infection. CIN3 detection is similar to that observed in routine European cytology-based screening programmes (CIN3+: 2.7‰); 5-year intervals may provide reasonable protection but longer intervals are not recommended. Tweetable abstract: A screening interval of 5 years (but no longer) appears safe in women with transient HPV detection.

Original languageEnglish
Pages (from-to)1365-1371
Number of pages7
JournalBJOG: An International Journal of Obstetrics and Gynaecology
Issue number11
Publication statusPublished - Oct 1 2019


  • Cervical cancer screening
  • CIN2
  • CIN3
  • HPV
  • screening interval
  • transient infection

ASJC Scopus subject areas

  • Obstetrics and Gynaecology


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