HPV testing may replace Pap smears for primary screening
The Journal of Family Practice. 2004 April;53(4):261-268
April 1, 2004|The Journal of Family Practice
Author and Disclosure Information
- CLINICAL QUESTION: Can human papillomavirus testing replace Papanicolaou tests as the primary means of screening for cervical cancer?
- STUDY DESIGN: Randomized controlled trial (nonblinded)
- SETTING: Outpatient (primary care)
- SYNOPSIS: In this multicenter screening study, 11,085 women aged 30 to 60 years were recruited from 161 family practices in the United Kingdom. To be eligible, the women could not have had an abnormal Pap result in the preceding 3 years and could never have been treated for cervical intraepithelial neoplasia (CIN). Women had a standard Pap test using an extended-tip Ayre’s spatula and a sample was placed into transport medium. Women with mild dyskaryosis or worse were referred for colposcopy.
BOTTOM LINE
Using human papillomavirus (HPV) testing is likely to replace Papanicolaou (Pap) testing for primary screening for cervical cancer for a variety of reasons—detection of the etiologic factor should predate the development of disease; urine testing for HPV may remove patient barriers to screening; and reduced interpretation error. This study can’t really provide the kind of data to support this, however. It is even more likely that vaccination against HPV may render both these technologies obsolete. (LOE=2b)
