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Study supports new screening method for cervical cancer

A pilot study of screening for high risk human papillomavirus in England finds it has greater sensitivity than liquid-based cytology testing

A pilot study of screening for high risk human papillomavirus in England finds it has greater sensitivity than liquid-based cytology testing


Cervical cancer cells dividing. Picture: SPL

A national roll-out of screening for routine primary high risk human papillomavirus (hrHPV) is under way in England. To support it, a large pilot study of routine testing for hrHPV examined the prevalence and incidence of cervical intraepithelial neoplasia (CIN, the pre-cancerous abnormalities) and cancer, comparing it with liquid-based cytology (LBC).

Testing was conducted in 2013-14, with follow-up in 2017.

Women testing hrHPV positive and cytology positive were referred for colposcopy, while those hrHPV positive but cytology negative were recalled early (at 12 months) for retesting. Those having hrHPV testing had 80% more colposcopies than those having only LBC, but detection of CIN was substantially more, with 50% CIN grade 2 or worse and 30% more with cervical cancer.

High attendance

There was a high level of attendance at early recall appointments (80%) and colposcopy referrals (95%). One quarter of the CIN grade 2 or worse identified were detected after early recall for repeat screening in women who initially tested positive for hrHPV but with negative cytology.

At usual recall three years later, those women initially screened with hrHPV testing had substantially less CIN grade 3 or worse than those screened only with LBC. The hrHPV test was shown to have greater sensitivity than LBC.


Vari Drennan is professor of healthcare and policy research at Kingston University and St George’s, University of London

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