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HPV testing in routine cervical screening: cross sectional data from the ARTISTIC trial.
H C Kitchener1, M Almonte, P Wheeler
1Division of Human Development, University of Manchester, Hathersage Road, Manchester M13 0JH, UK. henry.kitchener@cmmc.nhs.uk
British Journal of Cancer
|June 15, 2006
Summary
Human papillomavirus (HPV) testing is effective for primary cervical screening, showing high prevalence in young women. While practicable, HPV testing under age 30 may increase referrals.
Area of Science:
- Gynecology
- Oncology
- Virology
Background:
- Cervical cancer screening relies on cytology, but human papillomavirus (HPV) testing offers a more sensitive approach.
- Primary HPV testing is being evaluated as a potential improvement over traditional cervical screening methods.
Purpose of the Study:
- To assess the effectiveness and feasibility of using HPV testing as a primary screening tool for cervical cancer.
- To determine HPV prevalence in relation to age, cytological, and histological findings.
Main Methods:
- A cross-sectional study involving 24,510 women aged 20-64 undergoing routine cervical screening.
- Simultaneous screening for HPV and liquid-based cytology (LBC) was performed.
Main Results:
- HPV prevalence decreased with age, from 40% in women aged 20-24 to 7% in those over 50.
- HPV detection rates significantly increased with cytological abnormality, reaching 96% in severe dyskaryosis.
- HPV types 16 and 18 were most prevalent in severe cases (64%), but other types contributed to 30% of high-grade disease.
Conclusions:
- HPV testing is a viable primary screening method for cervical cancer.
- Implementing HPV testing in women under 30 may increase retesting and referral rates.
- While HPV 16/18 are key, a broader range of HPV types are implicated in high-grade cervical disease.