Study supports HPV-only screening

A single high-risk human papilloma virus (HR-HPV)-positive test can predict the development of cervical neoplasias for up to 18 years, a large, American study shows.

The findings could help inform changes to the NHS Cervical Screening Programme (NHSCSP) and come shortly after the UK National Screening Committee (UK NSC) announced that it is to launch a pilot study of HPV testing as the primary cervical screen.

The study, published in the Journal of Clinical Oncology, found that while a negative Pap result could strongly predict disease within the first 2 years, an HR-HPV-positive test continued to predict risk over the 18 years of the study.

A negative HR-HPV test also provided greater reassurance than a negative Pap test over 18 years, report Dr Philip Castle (American Society for Clinical Pathology, Washington, DC) and colleagues. For example, of patients developing invasive cervical cancer (CIN3 +), 67% had a normal Pap result at enrollment, while 44% had a negative HR-HPV result.

The NHSCSP is currently working with the UK NSC to develop the pilot, which they say is crucial before undertaking the substantial planning involved in an HPV-testing roll-out.

However, writing on the Cancer Research UK website, Professor Peter Sasieni (Queen Mary's University of London, UK) pressed for urgency, saying that he believes the evidence for HPV-only testing is now overwhelming.

"Plans should be made for the roll out of HPV testing nationally within the next five to six years, so that all women can benefit from these advances," he says.

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