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CAN HPV BE THE SOLE PRIMARY CERVICAL CANCER SCREENING TEST?
Author(s) -
Cuzick J.
Publication year - 2006
Publication title -
cytopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.512
H-Index - 48
eISSN - 1365-2303
pISSN - 0956-5507
DOI - 10.1111/j.1365-2303.2006.00392_2_1.x
Subject(s) - ascus (bryozoa) , medicine , cytology , triage , cervical cancer , gynecology , cervical cancer screening , human papilloma virus , test (biology) , pap test , obstetrics , cervical screening , cancer , oncology , pathology , medical emergency , paleontology , biology , botany , ascospore , spore
Infection by certain types of human papilloma virus is now recognised as the main factor for cervical cancer. About 50% of cancers contain HPV 16 and over 95% contain one or more of the high‐risk types (16, 18, 31, 33, 35, 45, 51, 52, 56, 58). Several studies have shown that HPV testing is considerably more sensitive than conventional cytology. However it is not as specific, especially for younger women. These studies will be reviewed and overall comparisons with cytology will be made. Data from the 11 000 women HART study will be presented which suggest that for women aged 30 or over, a rational strategy would be to use HPV testing as the sole primary screening test, reserving cytology for the triage of HPV positive women. The results of this study indicate that HPV positive cytology negative women can be safely managed by repeat testing at one year. This reverses the current role of HPV testing as a triage test for women with borderline (ASCUS) cytology. Use of liquid‐based collection media will facilitate the transition to this new approach to screening. A detailed algorithm will be presented.