Convincing data have shown that human papillomavirus (HPV)-DNA testing predicts the development of high-grade cervical cancer better than cytology. However, for HPV-positive women, triage with cytology testing should be performed before colposcopy. The question on how to proceed if the cytology test in HPV-positive women is negative remains unclear.
Key Points
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Cervical cancer screening should be done by HPV-DNA testing alone
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Cytology or cytology with HPV 16 and HPV18 genotyping can be used to triage HPV-positive women for colposcopy
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The exact algorithm to be used for triage depends on the quality of cytology and the minimum positive predictive value for CIN3+ referral acceptable by local health decision makers
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C. J. L. M. Meijer has acted as consultant for Qiagen, GlaxoSmithKline and Merck; has received honoraria from Qiagen and Roche; has received research support from Abbott; is a stockholder in Self-Screen; and holds a patent with MDxHealth. J. Berkhof has received honoraria from Qiagen.
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Meijer, C., Berkhof, J. Cervical cancer—should we abandon cytology for screening?. Nat Rev Clin Oncol 9, 558–559 (2012). https://doi.org/10.1038/nrclinonc.2012.161
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DOI: https://doi.org/10.1038/nrclinonc.2012.161
