Cervical HPV screening every six years may be safe and effective

Data from six European countries suggest that the length of HPV cervical screening intervals may be safely increased among women with negative HPV test results.

Researchers conducted a joint database analysis of seven primary HPV screening studies in Sweden, France, Germany, the United Kingdom, Denmark and Spain.

The study included 24,295 women from pooled analyses. During six years of follow-up, 381 women developed histologically confirmed CIN3+.

Women with abnormal cytology and positive HPV test results at baseline had the highest positive predictive value for future CIN3+ (cumulative incidence rate, 34%).

After six years, the incidence rate was lower among women with negative HPV at baseline (0.27%) compared with women with negative cytology (0.97%). Women with negative cytology results after three years — the most commonly recommended screening interval in Europe — had a cumulative incidence rate of 0.51%.

The cumulative incidence rate of CIN3+ for women with normal cytology and positive HPV test results continued to increase during the study period and ultimately reached 10% after six years. Conversely, the incidence rate among women with abnormal cytology and negative HPV remained below 3%, according to the researchers.

BMJ. 2008;337:a1754.