Primary HPV screening is a method with higher sensitivity than cytology for detection of
high-grade cervical intraepithelial neoplasia, which is the precursor of cervical cancer. In
particular, HPV test is a better test for revealing adenocarcinomas, since these cancers
often show a normal cytology.
Cervical cancer screening at age 60:
Cytology is less effective in older women, and screening with cytology in women over 60 has
no documented effect. Today a large part of cervical cancer develop in women older than 60,
to whom no screening is offered. The prevalence of HPV is around 4% in this age group. Since
we know that testing negative for HPV gives a better long-term protection against cervical
cancer compared to cytology, primary screening for HPV in 60-year old women would give a
longer lasting protection in this high-risk group compared with today.
Cervical cancer screening at age 30-40:
HPV screening is most cost effective above 35 years of age. The reason for this is that HPV
is less prevalent at age 35 than in younger women and also because cervical cancer seldom
develops before this age. Since the HPV test has a negative predictive value (NPV) of almost
100% this could lead to longer screening intervals, which would be improve
cost-effectiveness.
Interventional
Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Screening
number of CIN 2+ cases for the two different diagnostic procedures
The number of women with CIN2+ detected by primary HPV testing will be compared with the number of women with CIN2+ detected by primary cytology
first evaluation, the 1 of january 2013
No
Joakim Dillner, MD, PhD
Principal Investigator
Karolinska Institutet
Sweden: Regional Ethical Review Board
SLL-KI-HPV
NCT01511328
January 2012
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