Should human papillomavirus DNA testing be offered in combination with cytology or as a sole primary screening test in cervical cancer prevention?

Evaluation of: Rijkaart DC, Berkhof J, van Kemenade FJ et al. HPV DNA testing in population-based cervical screening (VUSA-Screen study): results and implications. Br. J. Cancer 106(5), 975-981 (2012). Previous studies have shown that the combination of high-risk human papillomavirus (HPV) testing and cytology increases sensitivity for the detection of cervical intraepithelial neoplasia 3, a surrogate end point for the reduction of cervical cancer. This paper addressed three questions regarding the implementation of high-risk HPV testing within a cervical screening program. The main question addressed was whether high-risk HPV testing should be provided as a standalone primary screen or in combination with cytology. Management of HPV-positive women and the optimum age for HPV testing were also examined. Results identified limited benefit from co-testing compared with HPV testing alone and emphasized the importance of repeat testing for HPV-positive women with negative cytology triage at baseline, in all women from 30 years of age onwards