ArticlePathogens (Basel, Switzerland)2026
Genotype-Specific HPV E6/E7 mRNA Triage for Risk Stratification in HPV DNA-Positive Women with ASC-US/LSIL: A Population-Based Tromsø Cohort.
Article in Pathogens (Basel, Switzerland), 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
HPV DNA-positive women with ASC-US/LSIL cytology constitute a heterogeneous triage group. We evaluated genotype-specific HPV E6/E7 mRNA testing with PreTect HPV-Proofer'7 in a population-based cohort from Tromsø and compared the findings descriptively with a previously published cohort from Bodø. This retrospective quality-assurance study included 1006 HPV DNA-positive women with ASC-US/LSIL cytology screened between 2019 and 2024, with linkage to regional pathology records through 31 December 2025. The assay detects E6/E7 mRNA from HPV16, 18, 31, 33, 45, 52, and 58. ASC-US/LSIL accounted for 42.5% of linked HPV DNA-positive women in Tromsø compared with 22.3% in Bodø. Among the mRNA-tested ASC-US/LSIL cohorts, mRNA positivity was similar (40.8% vs. 44.6%). In Tromsø, CIN2+ was recorded in 26.1% of mRNA-positive and 7.9% of mRNA-negative women (RR 3.31, 95% CI 2.41-4.55), whereas CIN3+ was recorded in 3.9% and 1.0%, respectively (RR 3.88, 95% CI 1.53-9.82). For CIN2+, sensitivity was 69.5%, specificity 64.4%, PPV 26.1%, and NPV 92.1%. Among HPV16/18 DNA-positive women, CIN2+ risk was 42.7% in mRNA-positive and 13.4% in mRNA-negative women. Simulated mRNA-guided referral reduced immediate colposcopy referrals by 59.2%. Genotype-specific mRNA testing provided clinically relevant risk stratification, with directionally similar patterns being observed in the Tromsø and Bodø cohorts; however, mRNA-negative women require structured surveillance.
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