HPV testing for primary cervical cancer screening.
Longer screening intervals may become safe with HPV DNA testing. A screening policy based on stand-alone HPV DNA testing is ideal, with cytological tests only for triage of positive cases. (4) But while HPV tests look good, it is far too early to abandon traditional cytology, not least until cost-effectiveness is shown and there is a rapid, simple, accurate, and affordable HPV DNA test. Furthermore, large demonstration projects will be needed to evaluate new algorithms for screening, including triage of positive HPV DNA tests with perhaps repeat testing or possibly followed by cervical cytological testing. The optimal approach will depend on the prevalence of disease, access to screening, and available resources. (5)
(1.) Bulkmans NWJ, Berkhof J, Rozendaal L, et al. Human papillomavirus DNA testing for the detection of cervical intraepithelial neoplasia grade 3 and cancer: 5-year follow-up of a randomised controlled implementation trial. Lancet 2007;370:1764-72.
(2.) Mayrand M-H, Duarte-Franco E, Rodrigues I, et al. Human papillomavirus DNA versus Papanicolaou screening tests for cervical cancer. New England Journal of Medicine 2007;357(16):1579-88.
(3.) Naucler P, Ryd W, Tomberg S, et al. Human papillomavirus and Papanicolaou tests to screen for cervical cancer. New England Journal of Medicine 2007;357(16):1589-97.
(4.) Ronco G, Segnan N. HPV testing for primary cervical screening. Lancet 2007;370:1740-42.
(5.) Ronowicz CD. Molecular screening for cervical cancer--time to give up Pap tests? New England Journal of Medicine 2007;357(16):1650.
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|Title Annotation:||ROUND UP: Reproductive cancers|
|Publication:||Reproductive Health Matters|
|Date:||Nov 1, 2008|
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