HPV Testing Followed by Cytology and Repeat HPV Testing May Improve Cervical Cancer Screening

Extract

The use of human papillomavirus (HPV) DNA testing as an initial screening step followed by triage with a standard Pap test (cytology) and repeat HPV DNA testing may increase the accuracy of cervical cancer screening, according to a study in the Jan. 13 online issue of the Journal of the National Cancer Institute. Compared to cytology alone, the screening strategy improved detection of precancerous growths without a substantial increase in the number of false-positive tests.

Randomized trials have shown that using DNA testing for HPV—which is known to cause cervical cancer—in screening programs would increase detection of cervical intraepithelial neoplasia (CIN) compared with cytology. However, HPV DNA testing also results in a substantial increase in false-positive tests, which lead to unnecessary and costly retesting.

In the current study, Joakim Dillner, M.D. of Lund University in Malmö, Sweden, and colleagues compared the efficacy of 11 different screening strategies that used HPV DNA testing, cytology, or a combination of the two. To evaluate the different strategies the investigators retrospectively analyzed data from 6,257 women who were enrolled in the intervention arm of a large randomized screening trial, called Swedescreen, in which HPV DNA testing was used in addition to standard cytology.