ArticleGynecologic oncology2023
The combined finding of HPV 16, 18, or 45 and cytologic Atypical Glandular Cells (AGC) indicates a greatly elevated risk of in situ and invasive cervical adenocarcinoma.
Article in Gynecologic oncology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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14 citing papers in PubMed, 15 citations in OpenAlex.
- Additional Diagnostic Yield of Endocervical Curettage in Type 3 Transformation Zone for High-Grade Cervical Lesions: A Retrospective Analysis by Human Papillomavirus Genotype.Diagnostics (Basel, Switzerland) · 2026Article
- Data-augmented multistate modeling for chronic disease processes using cross-sectional studies: application to HPV and cervical precancer.Biostatistics (Oxford, England) · 2026Article
- Pathological outcomes in women with cervical adenocarcinomaFrontiers in oncology · 2026Article
- A Retrospective Analysis of Atypical Cervical Cytology: Correlating Bethesda Categories with HPV Genotyping and Histological Follow-Up.Journal of clinical medicine · 2025Article
- Whole-genome sequencing of 1,083 HPV45 cases and controls identifies genetic variants associated with glandular cervical lesions.International journal of cancer · 2025Article
- The Relationship Between Cervicovaginal Infection, Human Papillomavirus Infection and Cervical Intraepithelial Neoplasia in Romanian Women.Diseases (Basel, Switzerland) · 2025Article
- Diagnostic utility of cell block preparations from liquid-based cytology in cervical lesions: A comparative retrospective analysis.CytoJournal · 2025Article
- Risk factors associated with adverse outcomes after cervical conization in patients with cervical adenocarcinoma in situ.PloS one · 2025Article
- Somatic mutations in 3929 HPV positive cervical cells associated with infection outcome and HPV type.Nature communications · 2024Article
- Pap Cytology and Human Papillomavirus (HPV) Genotypes in Western Romania: A Retrospective Analysis.Cureus · 2024Article
- Calendar-period trends in cervical precancer and cancer diagnoses since the introduction of human papillomavirus and cytology co-testing into routine cervical cancer screening at Kaiser Permanente Northern California.Gynecologic oncology · 2024Article
- Comprehensive overview of genotype distribution and prevalence of human papillomavirus in cervical lesions.Gynecology and obstetrics clinical medicine · 2024Article
- The value of endocervical curettage for diagnosis of cervical precancers or worse at colposcopy of women with atypical glandular cells cytology.Frontiers in medicine · 2024Article
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16 authors at 8 institutions in 2 countries.
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Abstract
backgroundCervical screening has not effectively controlled cervical adenocarcinoma (AC). Human papillomavirus (HPV) testing is recommended for cervical screening but the optimal management of HPV-positive individuals to prevent AC remains a question. Cytology and HPV typing are two triage options to predict the risk of AC. We combined two potential biomarkers (atypical glandular cell, AGC, cytology and HPV-types 16, 18, or 45) to assess their joint effect on detecting AC.
methodsKaiser Permanente Northern California (KPNC) used triennial co-testing with cytology and HPV testing (positive/negative) for routine cervical screening between 2003 and 2020. HPV typing of a sample of residual HPV test specimens was performed on a separate cohort selected from KPNC (Persistence and Progression, PaP, cohort). We compared risk of prevalent and incident histologic AC/AIS (adenocarcinoma in situ) associated with preceding combinations of cytologic results and HPV typing. Risk of squamous cell cancer (SCC)/cervical intraepithelial neoplasia grade 3 (CIN3) (SCC/CIN3) was also included for comparison.
resultsAmong HPV-positive individuals in PaP cohort, 99% of prevalent AC and 96% of AIS were linked to HPV-types 16, 18, or 45 (denoted HPV 16/18/45). Although rare (0.09% of screening population), the concurrent detection of HPV 16/18/45 with AGC cytology predicted a highly elevated relative risk of underlying histologic AC/AIS; the absolute risk of diagnosing AC/AIS was 12% and odds ratio (OR) was 1341 (95%CI:495-3630) compared to patients with other high-risk HPV types and normal cytology. Cumulatively (allowing non-concurrent results), approximately one-third of the AC/AIS cases ever had HPV 16/18/45 and AGC cytology (OR = 1785; 95%CI:872-3656). AGC was not as strongly associated with SCC/CIN3.
conclusionDetection of HPV 16/18/45 positivity elevates risk of adenocarcinoma, particularly if AGC cytology is also found.
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