Women with one or more negative cervical co-tests with HPV and cytology screening have a lower risk for cervical cancer; therefore, it may be safe to extend screening intervals to every 5 years or more in these women, according to research published in Annals of Internal Medicine.
"Current U.S. cervical cancer screening and management guidelines do not consider previous screening history, because data on multiple-round HPV and cytology ‘co-testing’ have been unavailable," Philip E. Castle, PhD, MPH, from the Albert Einstein College of Medicine, and colleagues wrote.
Castle and colleagues conducted an observational cohort study to determine the cervical cancer risk in routine practice after a history of negative co-tests, HPV test or cytology results at 3-year intervals.
The researchers analyzed data of 990,013 women who had one or more co-tests between 2003 and 2014 from Kaiser Permanente Northern California’s integrated health care system to measure the 3- and 5-year risk for cervical intraepithelial neoplasia grade 3, adenocarcinoma in situ and cervical cancer. Among the included women, there was a variation in the number of negative co-tests both overall and within subgroups by either previous co-test results or baseline age.
Results showed that after each successive negative co-test screening round, the 5-year risk for cervical cancer diminished (0.098%, 0.052% and 0.035%). Regardless of the cytology result, the 5-year risk for cervical cancer after an HPV-negative co-test was similar to the performance of a negative co-test for each consecutive screening round (0.114%, 0.061% and 0.041%).
The cervical cancer risk for the cytology-negative co-test declined after each round regardless of the HPV result (0.199%, 0.065% and 0.043%). However, after an HPV-negative co-test result, 3- and 5-year risks were similar.