Many countries are transitioning to HPV testing for cervical cancer screening, despite a lack of long‐term experience. To anticipate multi‐round screening performance, we analyzed 15‐year HPV testing results at Kaiser Permanente Northern California (KPNC). We evaluated HPV test result patterns among women aged 30–64 undergoing triennial HPV/cytology cotesting at KPNC during 2003–2018. We calculated incidence rates and proportion of CIN3+ diagnoses associated with the most frequent HPV testing patterns overall and stratified by age. From 2003 to 2018, a total of 1,361,581 women had a valid HPV test result, and 7,087 were diagnosed with CIN3+. Incidence rates of CIN3+ after HPV positivity were lowest when HPV detection was new and highest in women with prevalent infections (770 vs . 13,910/100,000 person‐years). Repeat test negativity reduced subsequent incidence rates of CIN3+ to extremely low levels (18/100,000 person‐years following four consecutive negative results). For mixed patterns of positivity/negativity, the recency and frequency of positive tests were associated with increased rates of CIN3+ diagnosis. Most CIN3+ cases (76%) were diagnosed in women who were positive at baseline (the first known positive HPV result); 16% were attributed to apparent newly detected infections and 3% to possible reappearing infections. These results corroborate previous findings that current HPV positivity, particularly when prevalent rather than new, is associated with the highest rates of CIN3+. In a screening program implementing HPV testing, most CIN3+ is detected at the first HPV positive test.

中文翻译：

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进行多轮HPV检测后检测CIN3 +风险的研究：在北加州凯泽永久医院进行15年宫颈癌筛查经验的结果。

尽管缺乏长期经验，许多国家仍在过渡到HPV检测以筛查宫颈癌。为了预测多轮筛查的效果，我们分析了北加州凯撒永久居民（KPNC）的15年HPV检测结果。我们评估了2003-2018年间在KPNC接受三年期HPV /细胞学联合测试的30-64岁女性的HPV测试结果模式。我们计算了与最常见的HPV检测模式相关的CIN3 +诊断的发生率和比例，并按年龄进行了分层。从2003年到2018年，共有1,361,581名妇女具有有效的HPV检测结果，其中7,087名被诊断出患有CIN3 +。HPV阳性后新发现HPV阳性后CIN3 +的发生率最低，而感染率高的女性最高（770 vs。13,910 / 100,000人年）。重复测试阴性可将随后的CIN3 +发生率降至极低的水平（连续四个阴性结果后为18 / 100,000人年）。对于阳性/阴性的混合模式，阳性率和阳性率与CIN3 +诊断率增加相关。大多数CIN3 +病例（76％）被诊断为基线时为阳性的女性（首次已知的HPV阳性结果）。16％归因于明显的新发现的感染，而3％归因于可能再次出现的感染。这些结果证实了以前的发现，即当前的HPV阳性，特别是在流行而不是新发时，与CIN3 +的最高发生率有关。在实施HPV测试的筛查程序中，大多数CIN3 +在首次HPV阳性测试中被检测到。