ArticleEuropean journal of public health2026
Improving cervical screening risk stratification through extended human papillomavirus genotyping and age-specific data.
Article in European journal of public health, 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
High-risk human papillomavirus (HR-HPV) screening effectively reduces cervical cancer incidence, but limited specificity leads to excessive colposcopy referrals. Extended HR-HPV genotyping improves triage by accounting for genotype-specific oncogenic risks, offering a more precise framework for patient management than traditional pooled testing. This study analysed real-world screening data from a Finnish cohort of 2368 HR-HPV-positive women (Tampere region, 2017-2019) with up to 6.5 years of follow-up. Extended genotyping was performed using the Seegene Anyplex™II HPV28 Detection assay. Genotype-specific prevalence and cumulative incidence of histology-confirmed High-grade Squamous Intraepithelial Lesions or worse (HSIL+) were assessed and stratified by reflex cytology. Among 3099 detected HR-HPV genotypes, HPV16 was most prevalent (14.3%) and carried the highest HSIL+ risk (35.7%), followed by HPV33 (24.6%) and HPV18 (20.8%). A clear risk hierarchy emerged: the lowest-risk group (HPV59/39/68/51/56/66) had an HSIL+ incidence below 4.2%. Notably, HPV16-positive women with NILM/ASC-US cytology faced a 23.9% HSIL+ risk, exceeding the 21.1% risk seen in the lowest-risk genotype group even when accompanied by LSIL+ cytology. For those with both NILM/ASC-US and the lowest-risk genotypes, HSIL+ incidence was only 3.4%. A distinct hierarchy of oncogenic risk exists within this population-based cohort. Incorporating genotype-specific data into national screening algorithms is strongly supported. This allows for immediate colposcopy for high-risk groups (e.g. HPV16 with mild cytology) while justifying extended follow-up for lower-risk types, optimizing clinical resources and reducing unnecessary procedures.
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