ArticleCytopathology : official journal of the British Society for Clinical Cytology2026
RNA Extended Interventional Nucleic Acid (REINA) Longitudinal Study: Decreased Risk of CIN2+/CIN3+ With Low-Grade Cytology After A Previous Negative HPV Test.
Article in Cytopathology : official journal of the British Society for Clinical Cytology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo analyse the impact of a previous negative mRNA HPV test in the immediate and 6 year risk of developing CIN2+/CIN3+ lesions in women with low-grade (LG, including ASC-US and LSIL) cytology in the second round of cotest screening.
methodsA prospective longitudinal study with LBC (ThinPrep, Hologic) and mRNA Aptima HPV test. Cotest was performed to 5053 asymptomatic women aged 25-65 years within an opportunistic screening programme in Madrid. Women with LG cytology, regardless of the mRNA HPV test result, were followed up (FU) to 10 years. The interventional arm 'RNA-based Extended Interventional Nucleic Acid (REINA)' recruited 2000 women with negative results in the first round for a second cotest 4 years later, and were FU to 6 more years. The risk of a CIN2+/CIN3+ at 6 years after a first LG cytology was calculated.
resultsWith an unknown HPV history, 18.7% of mRNA HPV-positive women at first cotest had LG cytology. Their immediate CIN2+ and CIN3+ risks were 24.7% and 12.8%, respectively, increasing to 31.8% and 17.0% after a 6-year FU. The long-term incidence of CIN2+ was strongly associated with mRNA HPV infection (p = 0.00001). From REINA, 20% of women with a new positive mRNA HPV result at second cotest had LG cytology, carrying much lower immediate and 6-year cumulative CIN2/CIN3 risks (5.0% and 10.0% respectively).
conclusionsA previous negative Aptima mRNA HPV test confers a protective effect for CIN2+/CIN3+ in mRNA HPV-positive women with minor cytological changes. The adjusted risks impact patient management, decreasing colposcopy referrals.
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