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Human Papillomavirus (HPV) Persistence and Progression Cohort (PaP Cohort)

DCEG investigators teamed with Kaiser Permanente Northern California (KPNC) to create a repository of specimens with carcinogenic human papillomavirus (HPV) genotypes that would be useful for natural history studies of HPV typing, methylation, and HPV variant genomics. Since 2003, KPNC has routinely used an FDA-approved pooled-type DNA test for carcinogenic HPV (HC2) with cytology (“cotesting”) for cervical cancer screening in women 30 and older. 

Investigators have stored approximately 35,000 baseline specimens that have tested positive by HC2 and 5,000 specimens that have tested negative by HC2. They have genotyped specimens selected for testing based on clinical outcomes ascertained by linkage to the KPNC cytology and histology databases and KPNC's active yearly follow-up of all HC2-positive women. The investigators "followed" women for three years after enrollment ended in 2011 by banking their residual specimens collected at their return visits. The subsequent continuing follow-up has focused on incident precancer and cancer. At present, there are more than 110,000 stored specimens, with >20,000 genotyped. The first prospective analyses have confirmed that HPV 16 detection confers a greatly elevated risk of subsequent precancer/cancer, while separate detection of other HPV types yields less clear clinical value.

A new phase of this cohort study will be a comprehensive evaluation of candidate biomarkers for cervical cancer screening and triage for Improvement of Risk-Informed Screening.

For more information, contact Mark Schiffman.

Clinical Genetics Branch - Research Areas

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