A systematic review of the role of human papilloma virus (HPV) testing within a cervical screening programme: summary and conclusions

A systematic review of the available evidence on the role of HPV testing in cervical screening has been published by the Health Technology Assessment Committee of the UK Department of Health. The review summarized relevant da ta on testing methods, natural history, and prevalence of the virus in diff erent disease groups, Cost-effectiveness modelling was undertaken. Ten majo r conclusions were reached and are reported here. The key conclusions were that HPV testing was more sensitive than cytology, but that there were conc erns about specificity, especially in young women. The increased sensitivit y led to a recommendation that HPV testing be introduced on a pilot basis f or women with borderline and mild smears. HPV testing has great potential a s a primary screening test, but large trials are needed to properly evaluat e this application and to determine ii its introduction can reduce invasive cancer rates. There is an urgent need to undertake a large trial of HPV te sting in conjunction with other new technologies (liquid-based cytology and computer-assisted cytology reading) to determine the best way to integrate them into ongoing screening programmes. A range of issues including the ag e to start and stop screening, the appropriate screening interval, the role of seif-sampling for HPV testing and the choice of primary test (HPV and/o r cytology) require further evaluation. (C) 2000 Cancer Research Campaign.