A systematic review of the role of human papillomavirus testing within a cervical screening programme

Cuzick J, Sasieni P, Davies P, Adams J, Normand C, Frater A, van Ballegooijen M, van den Akker E
Record ID 31999009728
Authors' objectives:

1. To evaluate the available data concerning the role of HPV testing:

a. in primary screening, either alone or as an adjunct to cytology

b. to improve the management of women with low-grade cytological abnormalities

c. to improve the accuracy of follow-up after treatment of preinvasive or early invasive lesions.

2. To review the methods available for HPV testing and determine their appropriateness for widespread implementation.

3. To determine what future research is required to obtain more reliable answers about its use in screening.

Authors' recommendations: HPV testing is more sensitive than cytology for high-grade CIN, but has lower specificity, especially inyoung women. HPV testing cannot currently be recommended for widespread implementation. The evidence suggests it may be appropriate in certain limited situations such as the management of borderlinesmears or in older women when regular screening is problematic, so that high sensitivity is needed. Full evaluation of HPV testing should provide information on the length of protection after a negativeresult, and consideration should be given to a very large trial with a reduction in cancer incidence as the end-point. Further studies and modelling simulations are needed to evaluate the range of potential rolesand most cost-effective use of HPV testing, and how it should be implemented and integrated with other testing methodologies.
Authors' methods: Systematic review
Project Status: Completed
URL for project: http://www.hta.ac.uk/1086
Year Published: 1999
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: England, United Kingdom
MeSH Terms
  • Costs and Cost Analysis
  • Vaginal Smears
  • Papillomaviridae
  • Papillomavirus Infections
Organisation Name: NIHR Health Technology Assessment programme
Contact Address: NIHR Journals Library, National Institute for Health and Care Research, Evaluation, Trials and Studies Coordinating Centre, Alpha House, University of Southampton Science Park, Southampton SO16 7NS, UK
Contact Name: journals.library@nihr.ac.uk
Contact Email: journals.library@nihr.ac.uk
Copyright: 2009 Queen's Printer and Controller of HMSO
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.