Published 28 July 2009, doi:10.1136/bmj.b3005
Cite this as: BMJ 2009;339:b3005

Editorials

Cervical screening according to age and HPV status

Cytological screening under age 25 has very low effectiveness; after that HPV genotyping helps to stratify risk

The first 150 words of the full text of this article appear below.

Strong evidence is now available that testing for human papillomavirus (HPV) infection is more sensitive than cytology in detecting high grade cervical intraepithelial neoplasia, and some randomised controlled trials showed that HPV testing is able to detect, earlier than cytology, persistent and therefore clinically relevant neoplasia.^{1 2} However, HPV testing is less specific than cytology.³ The best management of HPV positive women is therefore of major concern.

In one of two linked articles (doi:10.1136/bmj.b2569),⁴ Castle and colleagues show that the risk of developing high grade cervical intraepithelial neoplasia in the next three to five years is much higher in women with HPV infection that has persisted for at least one year than in those in whom the infection cleared. This suggests that HPV positive women need repeat testing, with differential management of those with or without persistent infection. Randomised trials have shown that if only HPV positive women with . . . [Full text of this article]

¹ Unit of Cancer Epidemiology, Centre for Cancer Prevention, Via San Francesco da Paola 31, 10123 Turin, Italy, ² Unit of Cancer Epidemiology, Scientific Institute of Public Health, Brussels, Belgium

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This article has been cited by other articles:

• (2009). For Cervical Cancer, Age Matters -- Both the Woman's and Her HPV Infection's. JWatch Women's Health 2009: 3-3 [Full text]  
• O'Mahony, C., Steedman, N., Yong, M., Anderson, E. R, Finnegan, V., Price, L. (2009). Let's not screen women under 25 throughout the UK. BMJ 339: b3426-b3426 [Full text]  
• Franco, E. L (2009). Managing low grade and borderline cervical abnormalities. BMJ 339: b3014-b3014 [Full text]  

Rapid Responses:

Read all Rapid Responses

Cervical cytology in under 25 year olds? We have all the evidence, so why don’t we base some medicine on it ?

Colm P O'Mahony, et al.
bmj.com, 12 Aug 2009 [Full text]

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