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Related Experiment Videos

Human papillomavirus testing in primary cervical screening

J Cuzick1, A Szarewski, G Terry

  • 1Department of Mathematics, Statistics, and Epidemiology, Imperial Cancer Research Fund, London, UK.

Lancet (London, England)
|June 17, 1995
PubMed
Summary
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Human papillomavirus (HPV) testing can detect cervical intraepithelial neoplasia (CIN) 2/3 lesions missed by conventional cytology. While HPV testing shows promise in augmenting cervical cancer screening, it should not replace existing methods.

Area of Science:

  • Gynecology
  • Oncology
  • Virology

Background:

  • Cervical cancer screening relies on cytology, but some lesions are missed.
  • The role of human papillomavirus (HPV) testing in improving detection remains unclear.

Purpose of the Study:

  • To evaluate the effectiveness of HPV testing for specific types (16, 18, 31, 33) in detecting cervical intraepithelial neoplasia (CIN) 2/3 during routine screening.

Main Methods:

  • HPV testing was performed on samples from women undergoing routine cervical screening.
  • Women with dyskaryosis or high HPV levels were referred for colposcopy.
  • Detection rates and positive predictive values were analyzed for HPV types 16, 18, 31, and 33.

Main Results:

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  • HPV testing identified 44% of CIN 2/3 lesions that had negative cytology.
  • An additional 22% of CIN 2/3 lesions showed HPV positivity with mild or borderline cytology.
  • HPV types 16 and 31 demonstrated higher sensitivity and specificity for CIN 2/3 compared to types 18 and 33, though 25% of CIN 2/3 lesions were missed by these four types.

    • Conclusions:

    • HPV testing can augment, but not replace, conventional cytology for cervical cancer screening.
    • Further large-scale randomized trials are needed to assess the impact of HPV testing on invasive cervical cancer incidence.