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HPV Testing With Triage Beats Conventional Cytology

HPV DNA testing with cytology triage found superior to conventional cytology in cervical cancer screening

WEDNESDAY, April 28 (HealthDay News) -- Screening women with a human papillomavirus (HPV) DNA test first, with cytology triage if the result is positive, is more sensitive for the detection of cervical cancer and pre-cancerous lesions than conventional cytology, according to a study published online April 27 in BMJ.

Ahti Anttila, Ph.D., of the Finnish Cancer Registry in Helsinki, and colleagues randomized 58,076 women invited to cervical cancer screening programs in 2003 to 2005 to undergo HPV DNA testing with cytology triage for a positive result or to cytology without prior HPV DNA testing. The researchers correlated the screening results to incidence data for cervical cancer, cervical intraepithelial neoplasia (CIN) grade III, and adenocarcinoma in situ (combined in a composite outcome termed CIN III+) from the 2003 to 2007 national cancer registry.

The researchers found that the HPV group had 76 cases of CIN III+, including six cervical cancers, while the cytology group had 53 cases of CIN III+, including eight cervical cancers. The relative rate of CIN III+ in the HPV group compared to the cytology group was 1.44 among all the women invited for screening and 1.77 for the women who actually attended.

"When incorporated into a well established organized screening program, primary HPV screening with cytology triage was more sensitive than conventional cytology in detecting CIN III+ lesions. The number of cases of cervical cancer was small, but considering the high probability of progression of CIN III the findings are of importance regarding cancer prevention," the authors write.

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