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Randomized trials and meta-analyses comparing HPV testing with cytology show that HPV-based screening is more sensitive for detecting cervical intraepithelial neoplasia grade 2 or worse. The increased sensitivity allows longer screening intervals after a negative HPV test when implemented within an organized program. For clinicians, higher sensitivity comes with the need for effective triage because HPV infection is common and many infections are transient. Reflex cytology, genotyping and risk-based management can distinguish women who need immediate colposcopy from those who can be safely followed. The evidence therefore supports HPV-based screening when the healthcare system can deliver reliable follow-up.
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Randomized trials and meta-analyses comparing HPV testing with cytology show that HPV-based screening is more sensitive for detecting cervical intraepithelial neoplasia grade 2 or worse. The increased sensitivity allows longer screening intervals after a negative HPV test when implemented within an organized program. For clinicians, higher sensitivity comes with the need for effective triage because HPV infection is common and many infections are transient. Reflex cytology, genotyping and risk-based management can distinguish women who need immediate colposcopy from those who can be safely followed. The evidence therefore supports HPV-based screening when the healthcare system can deliver reliable follow-up.
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