Canfell K et al. - HPV testing increases detection of high-grade cervical intraepithelial neoplastic lesions and invasive cancer compared to cytology, but populations previously vaccinated with HPV have not been evaluated. In the current study, colposcopy referral and CIN2+ detection rates for HPV-screened versus cytology-screened women was conducted. Primary HPV screening was associated with significantly increased detection of high-grade precancerous cervical lesions compared to cytology. Although the point estimates for referral rates in women in each HPV-screened group were 41%–44% higher than cytology-screened women, the difference in referral rate between cytology- and HPV-screened women was not significant.

Methods

• A randomised trial of 5-yearly HPV screening versus 2.5-yearly liquid-based cytology (LBC) screening was conducted.
• 5006 eligible women were recruited; 22% were eligible for vaccination.

Results

• For the liquid-based cytology (LBC)-screened group, the overall referral and detected CIN2+ rates were 27/995 and 1/995, respectively.
• For the HPV+LBC triage, the overall referral and detected CIN2+ rateswere 75/1992 and 20/1992, respectively.
• For HPV+dual-stage (DS) triage, the overall referral and detected CIN2+ rateswere 79/2008 and 24/2008, respectively.