Screen with cytology triage catches more cancers than cytology alone

Primary human papillomavirus (HPV) DNA screening with cytology triage in a routine organized screening program detects more cervical intraepithelial neoplasia (CIN) III+ lesions in all age groups than conventional cytology, according to the findings of a recent randomized, population-based, longitudinal study from Finland.

In the study, which included data on more than 58,000 women, the relative rate of CIN III+ lesions in the HPV group versus the conventional group was 1.44 (95% CI, 1.01-2.05) among all women invited to participate and 1.77 (95% CI, 1.16-2.74) among those who were actually screened. The rate of cervical cancer between arms was 0.75 (95% CI, 0.25-2.16) among invitees and 1.98 (95% CI, 0.52-9.38) among attendees.

Among women with a normal or negative test result, the relative rate between groups of subsequent CIN III+ was 0.28 (95% CI, 0.04-1.17), suggesting a lower rate of CIN III+ for HPV screening than for conventional cytology.

Anttila A, Kotaniemi-Talonen L, Leionen M, et al. Rate of cervical cancer, severe intraepithelial neoplasia, and adenocarcinoma in situ in primary HPV DNA screening with cytology triage: randomised study within organized screening programme. BMJ. 2010;340:c1804.