Original Investigation

HPV, Cytology, and Cotest Cervical Cancer Screening and the Risk of Precancer

JAMA Network Open 10.1001/jamanetworkopen.2026.1304

March 11, 2026 at 11:00 AM EDT

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Is the addition of cytology to primary human papillomavirus (HPV) testing associated with improvement in cervical cancer screening?In this cohort study of cervical cancer screen testing approaches and risk of cervical precancer, after a negative HPV test (regardless of cytology results) the risk of precancer remained acceptably low (cumulative incidence risk, 0.41) throughout long-term follow-up.These results suggest that compared with primary HPV testing for cervical cancer screening, cotesting may yield limited benefits while increasing costs.

Corresponding Author: Anna Gottschlich, PhD, Wayne State University, 42 W Warren Ave, Detroit, MI 48202 (anna.gottschlich@wayne.edu).

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