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Objective: To assess the clinical values of extended human papillomavirus (HPV) genotyping in triage of high‐risk HPV‐positive women, focusing on the trade‐off between cervical precancer detections and colposcopy referrals. Methods: A bivariate random‐effects model was used to estimate the diagnostic accuracy of primary HPV screening with following triage strategies to detect cervical precancers: (i) partial genotyping for HPV16/18 combined with cytological testing at atypical squamous cells of undetermined significance threshold (used as the comparator), (ii) genotyping for HPV16/18/58/52, (iii) genotyping for HPV16/18/58/52/33, (iv) genotyping for HPV16/18/58/33/31, (v) genotyping for HPV16/18/58/52/33/31, and (vi) genotyping for HPV16/18/58/52/33/31/39/51. Internal risk benchmarks for clinical management were used to evaluate the risk stratification of each triage strategy. Results: A total of 16,982 women (mean age 46.1 years, range 17–69) were included in this analysis. For CIN3+ detection, triage with HPV16/18/58/33/31 genotyping achieved lower positivity (6.85% vs. 7.35%, p = 0.001), while maintaining similar sensitivity (91.35% vs. 96.42%, p = 0.32) and specificity (94.09% vs. 93.67%, p = 0.56) compared with the comparator strategy. Similar patterns were observed for CIN2+ detection. Women with a positive HPV16/18/58/33/31 genotyping test had high enough risk for CIN3+ for colposcopy referral, while the risk for women with a negative test was below the 1‐year return decision threshold according to internal benchmarks. Conclusions: Our findings suggested extended HPV genotyping is of potential to be used as a triage technique integrated into HPV‐based cervical cancer screening, leading to reduced need for colposcopy referral while maintaining similar disease detection and efficient risk stratification. [ABSTRACT FROM AUTHOR]

Background: Human papillomavirus (HPV) attributable cancer burden is currently unknown in China, which is essential to evaluate the potential benefit of existing HPVvaccines and to inform cancer control policy. Methods: We extracted data of cancer incidence and mortality in 2014 from Chinese Cancer Registry Annual Report, and data of national population from National Bureau of Statistics. HPV‐attributable cancer burden was estimated by incorporating cancer rates and population forecasts by sex, cancer site, age and geographical area, and then combined to corresponding population attributable fractions. Results: We estimated that there were 110 894 HPV‐attributable new cancer cases in China in 2014, including 99 253 cervical cancers, 4449 noncervical cancers in females and 7192 cancers in males. The age‐standardized incidence of HPV‐attributable cancers in China was 5.69 per 100 000 persons, being slightly higher in rural than urban areas. Specifically, 51.1% of HPV‐attributable cervical cancers were diagnosed in women aged 40‐54 years, while 75.8% of noncervical cancers were diagnosed at 45‐79 years of age. Among males, 53.4% of cancers were diagnosed at 55‐74 years of age. Thirty five thousand six hundred and eighty three HPV‐attributable cancer deaths were estimated, including 29 683 due to cervical cancer, and 2307 and 3693 due to noncervical cancer in females and males, respectively. Conclusions: The cancer burden attributable to HPV in China is substantial. HPV vaccination and cervical screening should be prioritized. [ABSTRACT FROM AUTHOR]