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Background: Several options for the triage of high-risk HPV screen-positive (hrHPV + ) women were assessed. Methods: This study incorporated CIN2 + cases and controls, all of whom tested hrHPV + and whose results of liquid-based cytology (LBC), HPV16/18 genotyping, and p16/Ki67 cytoimmunochemistry were available. Sensitivity and specificity for the CIN2 + of these triage tests were evaluated. Results: Absolute sensitivities of HPV 16/18 typing, LBC, and p16/Ki-67 cytoimmunochemistry for CIN2 + detection were 61.7%, 68.3%, and 85.0% for women with hrHPV + clinician-taken samples. Respective specificities were 70.5%, 89.1%, and 76.7%. The absolute accuracy of the triage tests was similar for women with a hrHPV + self-sample. P16/Ki-67 cyto-immunochemistry was significantly more sensitive than LBC although significantly less specific. Conclusions: All three single-test triage options, if positive, exceed the threshold of 20% risk at which colposcopy would be indicated. However, none of them conferred a post-test probability of CIN2 + &lt;2%; which would permit routine recall. P16/Ki-67 cytoimmunochemistry on HPV16/18 negative women had a post-test probability of CIN2 + of 1.7% and 0.6% if also LBC negative. Impact: This is one of the few studies to directly compare the performance of triage strategies of hrHPV + women, in isolation and combinations. It is the only study assessing triage strategies in women who test hrHPV + in self-taken vaginal samples. A combined triage option that incorporated HPV 16/18 typing prior to p16/ki-67 cytoimmunochemistry in HPV 16/18-negative women yielded a post-test probability of CIN2 + of &gt;20%, whereas women who tested negative had a probability of CIN2 + of &lt;2%. Cancer Epidemiol Biomarkers Prev; 26(11); 1629-35. ©2017 AACR .

Defining Optimal Triage Strategies for hrHPV Screen–Positive Women—An Evaluation of HPV 16/18 Genotyping, Cytology, and p16/Ki-67 Cytoimmunochemistry