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HPV testing: Indications of a benefit in primary screening
Date:1/24/2012

benefit for these two outcomes.

If solely the advanced precursors of cancer are considered (CIN3/CIS), the data only provide a "hint" of a benefit. This is primarily due to a relatively large study that showed no difference between the HPV group and the comparator group. The new category "hint" expresses that certain minimum requirements for the available studies are fulfilled, but that conclusions on benefit and harm are only of low certainty.

No evaluable data on survival and quality of life

Conclusions on overall survival, mortality related to cervical cancer, and quality of life are not possible, as no data or no evaluable data were available for these outcomes.

Neither were evaluable data on potential screening-related harm available. For instance, unnecessary diagnostic procedures (e.g. biopsies) as a result of false-positive test results may harm patients. Moreover, the diagnosis itself can be a psychological burden, triggering anxieties or feelings of guilt.

Harm can also be caused by over-treatment. It is notable that women with moderate grade (CIN2) or sometimes even low grade cancer precursors were also treated in the included studies; in a great number of cases these precursors regress and only rarely progress into cancer. However, it cannot be estimated on the basis of these studies how often women who underwent HPV testing and/or a Pap smear were subjected to unnecessary treatment.

No recommendation for specific screening strategy possible

The complex screening strategies applied in the studies varied greatly and can therefore hardly be compared with each other. This applies to the participants' age and the intervals between follow-up examinations, as well as to the questions in which sequence or combination the HPV or cytology test should be applied and what measures should be undertaken after certain test results.

The study results therefore do not allow a recom
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Contact: Dr. Anna-Sabine Ernst
presse@iqwig.de
49-221-356-850
Institute for Quality and Efficiency in Health Care
Source:Eurekalert

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