Title
Short-term repeat HPV testing for triaging HPV-positive women in cervical cancer screening
Date Issued
28 December 2025
Access level
1
Resource Type
Article
Author(s)
Baena A.
Baena A.
Picconi M.A.
Mendoza L.
Ferrera A.
Mesher D.
Lineros J.
Brizuela M.
Mongelos P.
Cabrera Y.
Fellner M.D.
Zambrana O.
García L.
Hernández P.
Bobadilla M.L.
Ramon M.
Venegas G.
Venegas G.
Villagra V.
Cruz A.
Rodríguez G.
Terán C.
Calderón A.
Wiesner C.
Herrero R.
Herrero R.
Almonte M.
Almonte M.
Sosa Quesada C.
Soilán A.
Salgado Y.
Rodríguez de la Peña M.
Rodriguez M.I.
Ramirez A.T.
Pinastel Monet R.
Pérez N.
Ortega M.
Murillo V.
Kasamatsu E.
Hernández M.d.l.L.
Gimenez D.
Flores B.
Figueroa J.
Correa R.M.
Colucci M.C.
Beracochea A.
Bellido-Fuentes Y.
Centre international de Recherche sur le Cancer
National Cancer Institute (NCI)
Instituto Nacional de Enfermedades Infecciosas
Instituto de Investigaciones en Ciencias de la Salud Universidad Nacional de Asuncion
Universidad Nacional Autónoma de Honduras
UK Health Security Agency
Instituto Nacional de Cancerología
Caja Costarricense de Seguro Social
Instituto de Investigaciones en Ciencias de la Salud Universidad Nacional de Asuncion
Universidad Nacional Autónoma de Honduras
Instituto Nacional de Enfermedades Infecciosas
Universidad San Francisco Xavier
Centro Hospitalario Pereira Rossell
Instituto Nacional de Salud Publica
Laboratorio Central de Salud Pública
Oncosalud, AUNA
Laboratorio Central de Salud Pública
Instituto Nacional de Salud Publica
Comisión Honoraria de Lucha contra el Cáncer
Universidad San Francisco Xavier
Caja Costarricense de Seguro Social
Instituto Nacional de Cancerología
Centre international de Recherche sur le Cancer
Instituto Costarricense de Investigacion y Ensenanza en Nutricion y Salud Costa Rica
Centre international de Recherche sur le Cancer
Organisation Mondiale de la Santé
Caja Costarricense de Seguro Social
Ministerio de Salud Pública y Bienestar Social
Instituto Nacional de Cancerología
Hospital Nacional “Prof Posadas”
Instituto de Investigaciones en Ciencias de la Salud Universidad Nacional de Asuncion
Centre international de Recherche sur le Cancer
Caja Costarricense de Seguro Social
Hospital de Clinicas Dr. Manuel Quintela
Ministerio de Salud Pública y Bienestar Social
Universidad San Francisco Xavier
Instituto de Investigaciones en Ciencias de la Salud Universidad Nacional de Asuncion
Organisation Mondiale de la Santé
Ministerio de Salud Pública y Bienestar Social
Universidad San Francisco Xavier
Secretaría de Salud
Instituto Nacional de Enfermedades Infecciosas
Instituto Nacional de Enfermedades Infecciosas
Centro Hospitalario Pereira Rossell
Consejo Nacional de Ciencia, Tecnología e Innovación Tecnológica
Abstract
Background: Persistent HPV infection causes cervical cancer, but most infections are transient. Triage methods identify high-risk women needing further evaluation or treatment. We assessed short-term repeat HPV testing as an alternative triage option. Methods: In ESTAMPA, women aged 30–64 years were screened with HPV testing (HC2 or Cobas) and cytology. Screen positives were referred to colposcopy approximately two months after screening, where cervical samples were collected again for repeat HPV testing. We evaluated the performance of repeat HPV for CIN3+ among HPV-positive women and explored its combination with limited HPV genotyping (HPV16/18). Results: Among 5390 HPV-positive women (including 629 CIN3 cases and 53 cancers), 61% retested positive at ~2 months (median: 1.8, interquartile range: 1.2–2.8). Repeat HPV sensitivity for CIN3+ was 81.5% (95% CI 77.2–85.2) for HC2 and 87.7% (83.7–90.8) for Cobas. Specificity was <50% with referral rates of 57.4% (55.7–59.0) and 68.2% (66.1–70.2) for HC2 and Cobas. HPV16/18 genotyping followed by repeat HPV among non-HPV16/18-positive women did not greatly improve performance. However, HPV16/18 positivity doubled the risk of CIN3+, supporting its combination with repeat HPV when available. Conclusions: Short-term repeat HPV testing could be a practical option for triaging HPV-positive women, either alone or in combination with limited HPV genotyping. Trial registration: ClinicalTrials.gov, NCT01881659
Start page
1844
End page
1853
Volume
133
Issue
12
OCDE Knowledge area
Ciencias médicas, Ciencias de la salud
Scopus EID
2-s2.0-105021932762
PubMed ID
Resource of which it is part
British Journal of Cancer
ISSN of the container
15321827
Sponsor(s)
This work was supported by IARC/WHO; the UNDP / UNFPA / UNICEF / WHO / World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP/WHO), a cosponsored programme executed by the World Health Organization (WHO); the Pan American Health Organization (PAHO); the National Cancer Institute (NCI) (Grant UH2/3 CA202730); the NCI Center for Global Health; Instituto Nacional del C\u00E1ncer from Argentina (Grant 2016-2018); Agencia Nacional de Promoci\u00F3n de la Investigaci\u00F3n, el Desarrollo Tecnol\u00F3gico y la Innovaci\u00F3n from Argentina (Grant PICT 0364-2016); the National Council for Science and Technology (CONACYT) from Paraguay (Grants 14-INV-036 & PINV18-256); Caja Costarricense del Seguro Social; and the National Cancer Institute of Colombia. The funders had no role in the design of the study, data collection, analysis, interpretation, manuscript preparation, or in the decision to publish the results. Where authors are identified as personnel of the International Agency for Research on Cancer / World Health Organization, the authors alone are responsible for the views expressed in this article and they do not necessarily represent the decisions, policy, or views of the International Agency for Research on Cancer / World Health Organization. Some of the authors are present or former staff members of the World Health Organization. The authors alone are responsible for the views expressed in this publication, and they do not necessarily represent the views, decisions, or policies of the institutions. AB was supported in part by an appointment to the US National Cancer Institute (NCI) Research Participation Program administered by the Oak Ridge Institute for Science and Education (ORISE) through an interagency agreement between the U.S. Department of Energy (DOE) and the National Institutes of Health (NIH). ORISE is managed by ORAU under DOE contract number DESC0014664. All opinions expressed in this paper are the author\u2019s and do not necessarily reflect the policies and views of NIH, NCI, DOE, or ORAU/ORISE. This research was supported in part by the Intramural Research Program of the National Institutes of Health (NIH). The contributions of the NIH author(s) are considered Works of the United States Government. The findings and conclusions presented in this paper are those of the author(s) and do not necessarily reflect the views of the NIH or the U.S. Department of Health and Human Services.