Accelerating Cervical Cancer Screening With Human Papillomavirus Genotyping

Introduction: Selective utilization of human papillomavirus (HPV) genotyping in cervical cancer screening can accelerate clinical management, leading to earlier identification and treatment of precan-cerous lesions and cancer. Specifically, immediate colposcopy (instead of 1-year return) is recom-mended in persons with normal cytology and HPV genotypes 16 and/or 18, and expedited treatment (instead of colposcopy) is recommended in persons with high-grade squamous intraepithelial lesion (HSIL) cytology and HPV genotype 16. The effects of implementing HPV testing and genotyping into a screening program are largely unknown.Methods: Average-risk persons aged 30-65 years screened for cervical cancer in the National Breast and Cervical Cancer Early Detection Program from 2019 to 2020 were included (N=104,991). Percentage HPV genotyping test positivity was estimated within cytology result cate-gories. Analyses were performed in 2022. Results: The most common abnormality was positive high-risk HPV testing with normal cytology, representing 40.1% (7,155/17,832) of all abnormal test result categories; HSIL cytology represented 3.0% (530/17,832) of all abnormal test result categories. In high-risk HPV-positive persons with normal or high-grade cytology, HPV genotyping could accelerate management (immediate colposcopy and expe-dited treatment) in 5.4% of all persons with abnormal screening test results; if HPV genotyping had been performed in all high-risk HPV-positive persons with normal or HSIL cytology, approximately 13.1% could have accelerated management. Conclusions: HPV genotyping in human papillomavirus-positive persons with normal or HSIL cytology could accelerate management in a sizable percentage of persons with abnormal test results and may be particularly useful in populations with challenges adhering to longitudinal follow-up. Am J Prev Med 2023;64(4):552-555.(c) 2022 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.