ArticleJournal of the National Cancer Institute2018
Relative Performance of HPV and Cytology Components of Cotesting in Cervical Screening.
Article in Journal of the National Cancer Institute, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 74 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
74 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Artificial intelligence for cervical cancer screening and diagnosis using Pap smear images: a systematic review.BMC cancer · 2026Pooled it
- 2019 ASCCP Risk-Based Management Consensus Guidelines for Abnormal Cervical Cancer Screening Tests and Cancer Precursors.Journal of lower genital tract disease · 2020Guideline
- Clinical Utility of Human Papillomavirus Genotyping in Cervical Cancer Screening: A Systematic Review.Journal of lower genital tract disease · 2020Pooled it
- The Cervical Cancer Paradox in Eastern Europe: How Knowledge and Institutional Trust Shape HPV Vaccination Attitudes in Romania.Medical sciences (Basel, Switzerland) · 2026Observational
- Human Papillomavirus-Related Cancer in People With HIV and Solid Organ Transplant Recipients.JAMA network open · 2026Article
- Self-collection for primary HPV screening using dry swabs: a review of clinical performance, laboratory considerations, and patient preferences.Journal of clinical microbiology · 2026Review
- Efficiency of Human Papillomavirus (HPV) Testing in Cervical Cancer Screening and Vaccination: A Review.Cureus · 2026Review
- Development of bioengineered SPIONs usingOpen life sciences · 2026Article
- Cervical Cancer Screening in Transition: Global Challenges and Local Realities.International journal of women's health · 2026Review
- Human Papillomavirus Viral Load as Triage Biomarker for High-Grade Cervical Lesions and Invasive Cervical Carcinoma: A Cross-Sectional Study.Health science reports · 2025Article
- Comparative Oncologic Outcomes in High-Risk Human Papillomavirus-Positive and -Negative Cervical Intraepithelial Neoplasia.Medical science monitor : international medical journal of experimental and clinical research · 2025Article
- Progress in the application research of cervical cancer screening developed by artificial intelligence in large populations.Discover oncology · 2025Review
- Utilization and outcomes of serial cervical cancer screening in a National Breast and Cervical Cancer Early Detection Program (NBCCEDP) in a non-Medicaid expansion state.Cancer causes & control : CCC · 2025Article
- Gynecologic Cancer Screening and Prevention: State of the Science and Practice.Current treatment options in oncology · 2025Review
- Retrospective Analysis of Human Papillomavirus Genotyping and Cytology (Pap Smears) in Cervical Cancer Screening: An Institutional Experience in the State of Oregon, USA.Diagnostics (Basel, Switzerland) · 2025Article
- The immediate risk of cancer and its precursor lesions in women with abnormal cervical glandular cytology.Journal of Cancer · 2025Article
- Primary human papillomavirus testing vs cotesting: clinical outcomes in populations with different disease prevalence.Journal of the National Cancer Institute · 2024Article
- Evidence of Decreased Long-term Risk of Cervical Precancer after Negative Primary HPV Screens Compared with Negative Cytology Screens in a Longitudinal Cohort Study.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2024Article
- Effectiveness of high-risk human papillomavirus genotyping for cervical cancer screening. A multicentre screening cohort study in rural China.Anales del sistema sanitario de Navarra · 2024Article
- A population based study on human papillomavirus infection and associated risk factors among women of the remote South Andaman Island, India.BMC women's health · 2024Article
14 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: The main goal of cervical screening programs is to detect and treat precancer before cancer develops. Human papillomavirus (HPV) testing is more sensitive than cytology for detecting precancer. However, reports of rare HPV-negative, cytology-positive cancers are motivating continued use of both tests (cotesting) despite increased testing costs. Methods: We quantified the detection of cervical precancer and cancer by cotesting compared with HPV testing alone at Kaiser Permanente Northern California (KPNC), where 1 208 710 women age 30 years and older have undergone triennial cervical cotesting since 2003. Screening histories preceding cervical cancers (n = 623) and precancers (n = 5369) were examined to assess the relative contribution of the cytology and HPV test components in identifying cases. The performances of HPV testing and cytology were compared using contingency table methods, general estimating equation models, and nonparametric statistics; all statistical tests were two-sided. Results: HPV testing identified more women subsequently diagnosed with cancer (P < .001) and precancer (P < .001) than cytology. HPV testing was statistically significantly more likely to be positive for cancer at any time point (P < .001), except within 12 months (P = .10). HPV-negative/cytology-positive results preceded only small fractions of cases of precancer (3.5%) and cancer (5.9%); these cancers were more likely to be regional or distant stage with squamous histopathology than other cases. Given the rarity of cancers among screened women, the contribution of cytology to screening translated to earlier detection of at most five cases per million women per year. Two-thirds (67.9%) of women found to have cancer during 10 years of follow-up at KPNC were detected by the first cotest performed. Conclusions: The added sensitivity of cotesting vs HPV alone for detection of treatable cancer affected extremely few women.
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