European Journal of Obstetrics, Gynecology, and Reproductive Biology · Nov 2026
Performance of HPV-test screening in young women: Results from a population-based study in Brazil
By Vale DB, Rego RM, Discacciati MG et al.
Background Brazil is transitioning to HPV-based cervical cancer screening. In this context, this study aimed to analyze outcomes in young women during the first five years of a population-based HPV-testing screening program. Methods We followed a prospective cohort of women screened in the first round of the program in the city of Indaiatuba, São Paulo state. The subjects were all women screened through the public health system in the period (2017–2023). We analyzed two groups: women aged 25–29 and 30–34. The main outcome was cervical intraepithelial neoplasia grade 3 or above (CIN3 + ). We estimated risk using relative risk with a 95 % confidence interval (RR). Results In this five-year study, we screened 2,742 women aged 25–29 and 2,552 women aged 30–34. The prevalence of HPV-positive tests (HPV + ) was 23.2 versus 16.6 per 100 women, respectively (RR 1.40, 1.26–1.57). The risk in women 25–29 was higher for 16/18+ (RR 1.40, 1.13–1.74); other high-risk types and abnormal cytology (RR 1.27, 1.01––1.61); and colposcopy referrals (12.7 % versus 9.4 %, RR 1.34, 1.15–1.57). The risk of CIN3 + was lower in women 25–29 (RR 0.58, 0.38;0.90) and in those 16/18+ (RR 0.53, 0.32–0.87). Conclusions A lower detection capacity in detecting precursor lesions was observed in women aged 25–29. The colposcopy referral rate was higher but not clinically significant. Genotyping was crucial for triaging higher-risk women. Policy summary It seems reasonable to recommend isolated HPV testing for women aged 25 to 29 years and withdraw cytology-based screening from primary health care to avoid resource overuse.