HPV screening offers greater protection against invasive cervical cancer than cytology, finds analysis

Screening for the human papillomavirus (HPV) is more effective at protecting against invasive cervical cancer than traditional cytology based screening, an analysis of four large trials has found.

Countries that currently screen for cervical cancer will probably incorporate HPV testing in their programmes in the future; and with a longer time between tests the cost of national programmes is likely to fall, commentators say.

In England women who have a borderline or abnormal result of a cytology (or smear) test are currently tested for HPV, but HPV screening is not used as the primary test in the screening programme.

Four large trials have compared the two methods of screening. These were conducted in England (the ARTISTIC trial), Sweden (Swedescreen), the Netherlands (POBASCAM), and Italy (NTCC), but all looked at precursors of cervical cancer. Because of small numbers of cases, none of the trials was sufficiently powered to detect whether screening for HPV was better than cytology at reducing the incidence of invasive cervical cancer.

To find out whether HPV testing offered any advantages over cytology in detecting invasive cancer, researchers combined the …