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HPV testing in primary cervical cancer screening HPV testing in primary cervical cancer screening - Individual patient data were collected for all European and North American studies where cervical cytology was routinely performed and HPV testing was included as an additional parallel test. The sensitivity and specificity of HPV testing were compared with routine cytology, both overall and for ages <35, 35-49 and 50+. The age-specific prevalence of high risk HPV was also analysed. HPV testing was more sensitive in detecting CIN2+ than cervical cytology (96.1% vs. 53.0%) but less specific (90.7% vs. 96.3%). The sensitivity of HPV testing was similar in all studies carried out in different areas of Europe and North America, whereas the sensitivity of cervical cytology was highly variable. HPV testing sensitivity was uniformly high at all ages, whereas the sensitivity of cytology was substantially better in women over the age of 50 than in younger women (79.3% vs. 59.6%). The specificity of both tests increased with age. In
conclusion, these results support the use of HPV testing as the sole primary
cervical cancer screening test, with cytology reserved for patients who test HPV positive.
Large demonstration projects are needed to entirely evaluate this strategy.
Bibliographic reference:
Jack Cuzick Cancer Research UK, Wolfson Institute of Preventive Medicine, London, United Kingdom
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