Brush-based cytology screening in the tonsils and cervix: there is a difference!

This perspective on the report by Fakhry and colleagues in this issue of the journal (beginning on page 1378) examines the diagnostic accuracy of a "Pap-test equivalent" for screening for human papillomavirus (HPV)-associated cancers in the tonsils. HPV infection is strongly associated with cancer development in the oropharynx (tonsils and base of tongue) and cervix; the data discussed here underscore the differences in screening for cervical versus oropharyngeal malignancies and discuss some of the challenges and limitations associated with screening for tonsillar premalignancy and early cancers.