Journal
EUROPEAN JOURNAL OF CANCER PREVENTION
Volume 21, Issue 1, Pages 73-81Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/CEJ.0b013e3283498dbe
Keywords
age groups; cervical cancer; cytology; early detection of cancer; human papillomavirus DNA probes
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Funding
- Olga and Esper Boels Fund
- Aase og Ejnar Danielsens Fond
- Augustinus Fonden
- Fabrikant Mads Clausens Fond
- Familien Hede Nielsens Fond
- Else og Mogens Wedell-Wedellsborgs Fond
- Carl og Ellen Hertz' Legat til Dansk Laege-og Naturvidenskab
- Kobmand Sven Hansen og hustru Ina Hansens Fond
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Cervical screening with human papillomavirus (HPV) testing is less specific for high-grade cervical intraepithelial neoplasia (>= CIN3) than cytology. The aim of this systematic review was to determine whether a restriction of HPV testing to women aged at least 30 years would eliminate the problem. On the basis of the data from randomized controlled trials, we calculated the relative detection of CIN1 and CIN2, and the relative risks of false-positive tests (positive tests without subsequent >= CIN3) per age group and trial for HPV testing versus cytology. For women aged at least 30 years in trials with a low cytology abnormality rate, detection of CIN1 increased significantly by 50-90% in the two trials with reported data; detection of CIN2 was doubled in three trials; the risks of false-positive HPV tests were also doubled. In trials with a high cytology abnormality rate, these risks were similar for HPV testing and cytology. Adverse effects of HPV testing were for both types of cytology settings, generally higher for women below than above the age of 30. Adverse effects were less common among women aged at least 30 years than among younger women. However, in older women HPV testing still led to more CIN1/CIN2 diagnoses and false-positive tests than cytology. European Journal of Cancer Prevention 21:73-81 (C) 2011 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.
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