This article is more than 5 years old. Information may no longer be current.

HPV testing more effective than cytology in preventing invasive cervical cancer

Add topic to email alerts

Receive an email when new articles are posted on

Please provide your email address to receive an email when new articles are posted on .

Subscribe

Added to email alerts

You've successfully added to your alerts. You will receive an email when new content is published.

Click Here to Manage Email Alerts

You've successfully added to your alerts. You will receive an email when new content is published.

Click Here to Manage Email Alerts

Back to Healio

We were unable to process your request. Please try again later. If you continue to have this issue please contact customerservice@slackinc.com.

Back to Healio

HPV–based screening detected high-grade lesions earlier than cytology screening alone, thus preventing more invasive cervical cancer. However, HPV testing in younger women led to over diagnosis of cervical intraepithelial neoplasia compared with cytology.

“For women aged 35 years or more, our results support the use of HPV-DNA testing for primary screening at prolonged intervals, with cytology reserved for triage of HPV–positive women,” researchers wrote.

The New Technologies for Cervical Cancer (NTCC) screening study was designed to examine the benefits and risks of introducing HPV testing for cervical cancer screening and to assess the most appropriate age for initiating HPV testing. In it, researchers randomly assigned 47,001 patients to conventional cytology and 47,369 to HPV testing.

There were two rounds of screening. In round one, the intervention was thin-layer cytology plus HPV testing. In round two, the interventional was HPV testing alone.

A similar number of cervical cancers were detected in each group during the first round (P=.62). However, during the second round, no cancers were detected in the HPV group whereas nine were detected in the cytology group (P=.004). Overall, seven cancers were detected in the HPV group vs. 18 in the cytology group (P=.028).

Among women aged 35 to 60 years, detection of central intraepithelial neoplasia 2 and 3 was higher in the HPV group compared with the cytology group during round one (relative detection ratio, 2.03; 95% CI, 1.60-2.57). In the second round, detection was lower in the HPV group than in the cytology group (relative detection ratio, 0.51; 95% CI, 0.28-0.93).

Among women aged 25 to 34 years, detection of CIN3 was higher in the HPV group than in the cytology group for round two, with a total detection ratio of 2.14 (95% CI, 1.28-3.59). When pooling data from both rounds, the ratio for detecting CIN2 for HPV vs. cytology was 4.54 (95% CI, 3.00-6.88) for round one, and 0.54 (95% CI, 0.23-1.27) for round two, according to the researchers.

Ronco G. Lancet Oncol. 2010;doi:10.1016/S1470-2045(09)70360-2.