Real-World Outcomes of HPV Testing as a Primary Cervical Cancer Screen

Several randomized trials have shown that, compared with cervical cytology, testing for high-risk human papillomavirus types (hrHPV) identifies more women with cervical intraepithelial grade ≥2 (CIN 2+) during the initial screen. Subsequent incidence of CIN 2+ is lower, allowing longer intervals between screens. The U.K. cervical screening program has been monitoring the yield of cytology versus HPV among 578,547 women (age range, 24–64), 32% of whom underwent hrHPV testing. Follow-up for HPV 16/18 positivity included early recall or colposcopy referral per standard guidelines.

Among women screened for hrHPV, detection rates were higher for CIN 2+ (odds ratio, 1.5), CIN 3+ (OR, 1.4), and cervical cancer (OR, 1.3); also, such women were more …