HPV Testing: Coming of Age as a Primary Screen for Cervical Cancer

Cervical human papillomavirus (HPV) testing definitively lowers incidence of subsequent cervical intraepithelial neoplasia (CIN; the precursor to cervical cancer), but whether HPV testing should be used alone (i.e., without cytology) is less clear. Investigators in British Columbia randomized 19,000 women (age range, 25–65) to receive HPV testing alone (and, if negative, to be rescreened at 48 months with HPV and liquid-based cytology [LBC]) or LBC at enrollment and 24 months (and, if negative, screening with HPV and LBC at 48 months). Women who tested positive were followed per current guidelines (e.g., reflex LBC or HPV testing, colposcopy).

The overall incidence of CIN grade 3 or worse (CIN3+) at 48 months was significantly lower among wo…