Having a 30-year follow-up of a cohort of women tested for HPV is a unique opportunity to further study long-term risk of CIN3+. The study objective was to compare HPV status at baseline with the risk of CIN3+ in the follow-up period of 30 years. All women (n = 642) referred to the HPV outpatient clinic at the University Hospital of North Norway (UNN) in 1990–1992, with an HPV test at baseline, were included in a prospective cohort. HPV-testing was performed by two different HPV-DNA tests, and genotypes 6, 11, 16, 18, 31 and 33 were identified. High-risk (HR) HPV genotypes (16, 18, 31 and 33) were classified as HPV positive, whereas low-risk (LR) genotypes (6 and 11) in addition to absent HPV were classified as HPV negative. A single cohort in which women were classified for their HPV status underwent follow-up prospectively to the last time-point of observation of 30 years. During follow-up, 148 (148/642) cases of CIN3+ were detected, of whom 70.3% (104/148) were HPV positive and 29.7% (44/148) were HPV negative at baseline. The proportions of women who developed CIN3+ following a positive and a negative test were 46.6% (104/223) and 10.5% (44/419), respectively. Most cases of CIN3+ were seen shortly after the baseline HPV test, with 112 cases of CIN3+ diagnosed within the first year. In total, 48.6% (72/148) with HPV 16 and 57.6% (19/33) with HPV 33 developed CIN3+. Within the first year, CIN3+ was detected in 37.8% (56/148) with HPV 16, and 51.5% (17/33) with HPV 33. The long-term risk of CIN3+ was significantly lower than the short-term risk, and mainly associated with HPV 16. Overall, eight cases of cervical cancer were detected. Five were HPV positive, harboured HPV 16 at baseline and developed cervical cancer after 3, 4, 5, 11 and 24 years of follow-up. HPV status at baseline is predictive for the subsequent risk of developing CIN3+. Women with a positive HPV test in 1990–1992 had a significantly higher risk of CIN3+ during 30 years of follow-up than those with a negative test. HPV 16 was associated with the greatest long-term risk of cervical cancer. All patients with a positive HPV test at baseline should be followed up until negative. ISRCTN, ISRCTN10836802 . Registered 14 December 2020 - Retrospectively registered.

中文翻译：

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1990-1992 年接受 HPV 检测的女性宫颈上皮内瘤变 3 级或更高 (CIN3+) 的风险，一项为期 30 年的随访研究

对一组接受 HPV 检测的女性进行 30 年的随访是进一步研究 CIN3+ 长期风险的独特机会。研究目的是比较基线时的 HPV 状态与 30 年随访期间 CIN3+ 的风险。所有在 1990-1992 年转诊到北挪威大学医院 (UNN) HPV 门诊并在基线时进行 HPV 检测的女性（n = 642）都被纳入前瞻性队列。HPV 检测通过两种不同的 HPV-DNA 检测进行，并确定了基因型 6、11、16、18、31 和 33。高危 (HR) HPV 基因型（16、18、31 和 33）被归类为 HPV 阳性，而低危 (LR) 基因型（6 和 11）除了不存在 HPV 外，还被归类为 HPV 阴性。根据 HPV 状态对女性进行分类的单个队列进行了前瞻性随访，直至最后一个观察时间点为 30 年。在随访期间，检测到 148 (148/642) 例 CIN3+，其中 70.3% (104/148) 为 HPV 阳性，29.7% (44/148) 为基线 HPV 阴性。在阳性和阴性测试后发展为 CIN3+ 的女性比例分别为 46.6% (104/223) 和 10.5% (44/419)。大多数 CIN3+ 病例是在基线 HPV 检测后不久发现的，在第一年内诊断出 112 例 CIN3+。总共有 48.6% (72/148) 的 HPV 16 和 57.6% (19/33) 的 HPV 33 发生 CIN3+。在第一年内，37.8% (56/148) HPV 16 和 51.5% (17/33) HPV 33 检测到 CIN3+。 CIN3+ 的长期风险显着低于短期风险，并且主要与HPV 16 相关。总共检测到8 例宫颈癌。其中 5 人为 HPV 阳性，基线时携带 HPV 16，并在随访 3、4、5、11 和 24 年后发展为宫颈癌。基线 HPV 状态可预测后续发生 CIN3+ 的风险。在 1990 年至 1992 年期间，HPV 检测呈阳性的女性在 30 年的随访期间发生 CIN3+ 的风险显着高于检测呈阴性的女性。HPV 16 与宫颈癌的最大长期风险相关。所有在基线时 HPV 检测呈阳性的患者都应进行随访直至阴性。ISRCTN，ISRCTN10836802。2020 年 12 月 14 日注册 - 追溯注册。11 年和 24 年的随访。基线 HPV 状态可预测后续发生 CIN3+ 的风险。在 1990 年至 1992 年期间，HPV 检测呈阳性的女性在 30 年的随访期间发生 CIN3+ 的风险显着高于检测呈阴性的女性。HPV 16 与宫颈癌的最大长期风险相关。所有在基线时 HPV 检测呈阳性的患者都应进行随访直至阴性。ISRCTN，ISRCTN10836802。2020 年 12 月 14 日注册 - 追溯注册。11 年和 24 年的随访。基线 HPV 状态可预测后续发生 CIN3+ 的风险。在 1990 年至 1992 年期间，HPV 检测呈阳性的女性在 30 年的随访期间发生 CIN3+ 的风险显着高于检测呈阴性的女性。HPV 16 与宫颈癌的最大长期风险相关。所有在基线时 HPV 检测呈阳性的患者都应随访至阴性。ISRCTN，ISRCTN10836802。2020 年 12 月 14 日注册 - 追溯注册。所有在基线时 HPV 检测呈阳性的患者都应进行随访直至阴性。ISRCTN，ISRCTN10836802。2020 年 12 月 14 日注册 - 追溯注册。所有在基线时 HPV 检测呈阳性的患者都应进行随访直至阴性。ISRCTN，ISRCTN10836802。2020 年 12 月 14 日注册 - 追溯注册。