• George F Sawaya, Mona Saraiya, Ashwini Soman, Sameer V Gopalani, Kristy Kenney, and Jacqueline Miller.
• Department of Obstetrics, Gynecology & Reproductive Sciences, University of California San Francisco (UCSF), San Francisco, California; Center for Healthcare Value, University of California San Francisco (UCSF), San Francisco, California. Electronic address: george.sawaya@ucsf.edu.
• Am J Prev Med. 2023 Apr 1; 64 (4): 552555552-555.

IntroductionSelective utilization of human papillomavirus (HPV) genotyping in cervical cancer screening can accelerate clinical management, leading to earlier identification and treatment of precancerous lesions and cancer. Specifically, immediate colposcopy (instead of 1-year return) is recommended 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.MethodsAverage-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 categories. Analyses were performed in 2022.ResultsThe 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 expedited 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.ConclusionsHPV 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.Copyright © 2022 American Journal of Preventive Medicine. All rights reserved.

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