HPV-Based Screening Beats Cytology for Invasive Cervical CA
Follow-up of four trials shows HPV screening more efficacious for preventing invasive cervical carcinoma
MONDAY, Nov. 4 (HealthDay News) -- For women who undergo regular screening, human papillomavirus (HPV)-based screening is more efficacious than cytology-based screening for the prevention of invasive cervical cancer, according to a study published online Nov. 3 in The Lancet.
Guglielmo Ronco, M.D., from the Center for Cancer Epidemiology and Prevention in Turin, Italy, and colleagues conducted a follow-up study of four randomized trials involving 176,464 women to examine the relative efficacy of HPV-based (experimental arm) versus cytology-based (control arm) screening for the prevention of invasive cancer in women who undergo regular screening. The women were followed for a median of 6.5 years.
The researchers found that, among all women, the rate ratio (experimental versus control) for invasive cervical cancer from recruitment to end of follow-up was 0.60, with no heterogeneity seen between studies. During the first 2.5 years of follow-up, detection of invasive cervical carcinoma was similar between screening methods, but thereafter was significantly lower in the experimental arm. The rate ratio was 0.30 for women with a negative screening test at entry. For women with negative entry tests, the cumulative incidence of invasive cervical carcinoma was 4.6 per 105 at 3.5 years and 8.7 per 105 at 5.5 years in the experimental arm, compared with 15.4 and 36.0 per 105, respectively, in the control arm.
"HPV-based screening provides 60 to 70 percent greater protection against invasive cervical carcinomas compared with cytology," the authors write.
Several authors disclosed financial ties to the pharmaceutical and biotechnology industries.