HPV Testing in Primary Cervical Screening: A Systematic Review and Meta-Analysis

Implementation Considerations Using HPV Self-Collection to Reach Women Under-Screened for Cervical Cancer in High-Income Settings

“…However, cytology for primary cervical cancer screening has a number of limitations including poor sensitivity, a taxing demand on human and operational infrastructure, high health system costs, and limited uptake rates, leading researchers and policy-makers to question whether further gains in public health are possible using this approach 2 . Persistent infection with high-risk genotypes of human papillomavirus (hpv) is well established as the necessary cause for development of cervical cancer 3 .…”

“…Persistent infection with high-risk genotypes of human papillomavirus (hpv) is well established as the necessary cause for development of cervical cancer 3 . Research has shown a 30% improvement in sensitivity in detecting high-grade lesions, cervical squamous intraepithelial neoplasia (cin) grade 2 or greater (cin2+), can be achieved with high-risk hpv dna testing compared with cytology 4 . A negative hpv test confers two-fold greater reassurance against the development of cervical cancer over three years compared with a negative cytology test 2,5 .…”

“…Research has shown a 30% improvement in sensitivity in detecting high-grade lesions, cervical squamous intraepithelial neoplasia (cin) grade 2 or greater (cin2+), can be achieved with high-risk hpv dna testing compared with cytology 4 . A negative hpv test confers two-fold greater reassurance against the development of cervical cancer over three years compared with a negative cytology test 2,5 . The Netherlands has recently transitioned from cytology to hpv testing for primary cervical cancer screening in their National program.…”

Combined CADM1/MAL Methylation and Cytology Testing for Colposcopy Triage of High-Risk HPV-Positive Women

“…However, the main drawback of the hrHPV test is its lower specificity for CIN2/3 or worse (CIN2/3 þ ) than cytology (5). To compensate for this limitation, different triage algorithms have been suggested aiming to reduce the number of hrHPVpositive women to be referred for colposcopy, thereby limiting overdiagnosis and overtreatment.…”

The Aptima HPV Assay Fulfills the Cross-Sectional Clinical and Reproducibility Criteria of International Guidelines for Human Papillomavirus Test Requirements for Cervical Screening

“…There is widespread interest in HPV testing as a primary tool for cervical screening given its higher sensitivity versus cytology for the detection of high-grade cervical intraepithelial neoplasia and cervical cancer (i.e., cervical intraepithelial neoplasia of grade 2 or worse [CIN2ϩ]), consequently offering better protection against cervical precancer/cancer (4,5). It is imperative, however, that HPV assays used for primary cervical screening have proven sufficient clinical performance for the detection of CIN2ϩ to allow effective detection of women with clinically meaningful cervical disease while minimizing the detection of women with transient HPV infections, to reduce unnecessary follow-up procedures (6).…”