Objective.: Addition of high-risk human papillomavirus (hrHPV) testing to post-treatment monitoring policies of women treated for high-grade cervical intraepithelial neoplasia (CIN) may improve the effectiveness of detecting recurrent/residual disease. Recent studies have shown that HPV type 16 confers an increased risk of high-grade CIN and cervical cancer. This study aimed to find out whether the post-treatment CIN3 rate is increased in HPV16-positive women treated for CIN3. Methods.: We included 229 hrHPV-positive women treated for CIN3. HPV typing was performed by GP5+/6+-PCR followed by reverse line blotting on a cervical scrape taken before treatment. HPV typing data were related to the occurrence of post-treatment CIN3 within a median follow-up time of 20.1 months (range 3-85.4 months) following treatment. Results.: Twenty nine of the 151 (19%) HPV16-positive women versus 6 of the 78 (8%) women with other hrHPV types had recurrent/residual CIN3. Post-treatment CIN3 rate was significantly increased in women with HPV16 compared to those harboring other hrHPV types (p = 0.03). None of the other hrHPV types were associated with higher post-treatment CIN3 rates. Conclusion.: Women treated for HPV16 containing CIN3 should be monitored more intensively because of their increased risk of post-treatment CIN3. Thus, the HPV genotype should be considered in post-treatment monitoring policies.

Cervical intraepithelial neoplasia, HPV16, HPV18, Human papillomavirus, Post-treatment CIN
dx.doi.org/10.1016/j.ygyno.2006.10.011, hdl.handle.net/1765/35609
Gynecologic Oncology
Erasmus MC: University Medical Center Rotterdam

Gök, M, Coupé, V.M.H, Berkhof, J, Verheijen, R.H.M, Helmerhorst, T.J.M, Hogewoning, C.J.A, … Meijer, C.J.L.M. (2007). HPV16 and increased risk of recurrence after treatment for CIN. Gynecologic Oncology, 104(2), 273–275. doi:10.1016/j.ygyno.2006.10.011