Short-term repeat HPV testing for triaging HPV-positive women in cervical cancer screening
Author(s)
Marı́a Alejandra Picconi
Laura Mendoza
Annabelle Ferrera
David Mesher
Johana Lineros
Marisol Brizuela
Pamela Mongelós
Yessy Cabrera
Marı́a Dolores Fellner
Osmalia Zambrana
Laura García
Pilar Hernández
María Liz Bobadilla
María Antonia Ramón
Gino Venegas Rodríguez
Verónica Villagra
Aurelio Cruz-Valdéz
Guillermo Rodríguez‐Domínguez
Carolina Terán
Alejandro Calderón
Carolina Wiesner
Rolando Herrero
Maribel Almonte
on behalf of the ESTAMPA study group
Yenny Bellido‐Fuentes
Andrea Verónica Beracochea
María Celeste Colucci
Rita Mariel Correa
Jacqueline Figueroa
Bettsy Flores
Diana Gimenez
María de la Luz Hernández
Elena Kasamatsu
Victoria Murillo
Marina Ortega
Natalia Pérez
Rolando Pinastel Monet
Arianis Tatiana Ramírez
Maria Isabel Rodríguez
Mercedes Rodríguez de la Peña
Yuli Salgado
Ana Soilán
Charles Quesada
Date Issued
3 de octubre de 2025
Type
Article
Volume
133
Issue
12
Start Page
1844
End Page
1853
Abstract
BACKGROUND: Persistent HPV infection causes cervical cancer, but most infections are transient. Triage methods identify high-risk women needing further evaluation or treatment. We assessed short-term repeat HPV testing as an alternative triage option. METHODS: In ESTAMPA, women aged 30-64 years were screened with HPV testing (HC2 or Cobas) and cytology. Screen positives were referred to colposcopy approximately two months after screening, where cervical samples were collected again for repeat HPV testing. We evaluated the performance of repeat HPV for CIN3+ among HPV-positive women and explored its combination with limited HPV genotyping (HPV16/18). RESULTS: Among 5390 HPV-positive women (including 629 CIN3 cases and 53 cancers), 61% retested positive at ~2 months (median: 1.8, interquartile range: 1.2-2.8). Repeat HPV sensitivity for CIN3+ was 81.5% (95% CI 77.2-85.2) for HC2 and 87.7% (83.7-90.8) for Cobas. Specificity was <50% with referral rates of 57.4% (55.7-59.0) and 68.2% (66.1-70.2) for HC2 and Cobas. HPV16/18 genotyping followed by repeat HPV among non-HPV16/18-positive women did not greatly improve performance. However, HPV16/18 positivity doubled the risk of CIN3+, supporting its combination with repeat HPV when available. CONCLUSIONS: Short-term repeat HPV testing could be a practical option for triaging HPV-positive women, either alone or in combination with limited HPV genotyping. TRIAL REGISTRATION: ClinicalTrials.gov, NCT01881659.
Subjects