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Randomized screening trials show that primary high-risk HPV testing detects cervical intraepithelial neoplasia grade 2 or worse more sensitively than cytology alone. The increased sensitivity can permit longer intervals after a negative HPV test in organized programmes, but it also makes triage and follow-up essential because transient HPV infection is common. For gynecologists, the clinical pathway should therefore combine HPV testing with genotyping or reflex cytology and clear thresholds for colposcopy. The effectiveness of screening depends as much on completing the follow-up pathway as on the initial test.
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Randomized screening trials show that primary high-risk HPV testing detects cervical intraepithelial neoplasia grade 2 or worse more sensitively than cytology alone. The increased sensitivity can permit longer intervals after a negative HPV test in organized programmes, but it also makes triage and follow-up essential because transient HPV infection is common. For gynecologists, the clinical pathway should therefore combine HPV testing with genotyping or reflex cytology and clear thresholds for colposcopy. The effectiveness of screening depends as much on completing the follow-up pathway as on the initial test.
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