Evidence Regarding Human Papillomavirus Testing in Secondary Prevention of Cervical Cancer
Open accessAbstract
More than ever, clinicians need regularly updated reviews given the continuously increasing amount of new information regarding innovative cervical cancer prevention methods. A summary is given from recent meta-analyses and systematic reviews on 3 possible clinical applications of human papillomavirus (HPV) testing: triage of women with equivocal or low-grade cytologic abnormalities; prediction of the therapeutic outcome after treatment of cervical intraepithelial neoplasia (CIN) lesions, and last not but not least, primary screening for cervical cancer and pre-cancer. Consistent evidence is available indicating that HPV-triage with the Hybrid Capture(®) 2 assay (Qiagen Gaithersburg, Inc., MD, USA [previously Digene Corp.] (HC2) is more accurate (higher sensitivity, similar specificity) than repeat cytology to triage women with equivocal Pap smear results. Several other tests show at least similar accuracy but mRNA testing with the APTIMA(®) (Gen-Probe Inc., San Diego, CA, USA) test is similarly sensitive but more specific compared to HC2. In triage of low-grade squamous intraepithelial lesions (LSIL), HC2 is more sensitive but its specificity is substantially lower compared to repeat cytology. The APTIMA(®) test is more specific than HC2 without showing a loss in sensitivity. Identification of DNA of HPV types 16 and/or 18, or RNA from the five most carcinogenic HPV types allow selecting women at highest risk for CIN3+ but the sensitivity and negative predictive value of the…
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Screening by hrHPV testing is more effective than screening by cytology for protecting against future cervical precancer and cancer.
“We now have high level evidence that screening by hrHPV testing is more effective than screening by cytology for protecting against future cervical precancer and cancer.18 20”
From Detecting cervical precancer and reaching underscreened women by using HPV testing on self samples: updated meta-analyses (2018) · cites this paper as [18]
A proportion of screened women with cervical precancer and cancer show false negative Pap tests.
“Third, a proportion of screened women with cervical precancer and cancer show false negative Pap tests.18 19”
From Detecting cervical precancer and reaching underscreened women by using HPV testing on self samples: updated meta-analyses (2018) · cites this paper as [18]
HPV detection is the most superior primary screening test for detection of cervical intraepithelial neoplasia (CIN).
“Several randomized controlled trials and cross-sectional studies including a meta-analysis have shown that human papillomavirus (HPV) detection is the most superior primary screening test for detection of cervical intraepithelial neoplasia (CIN) [5] and is also recommended by the WHO in the 2021 guidelines [3].”
From Performance of HPV Self-Sample Collected by a Novel Kit in Comparison with Clinician Collected Sample for Cervical Cancer Screening (2024) · cites this paper as [5]
HPV testing has high sensitivity for detecting precancerous lesions in WLHIV and inherent advantages of objectivity and reproducibility compared to visual inspection methods like VIA or subjective assessments like cytology.
“The rationale for this choice lies in HPV testing’s high sensitivity for detecting precancerous lesions in WLHIV and its inherent advantages of objectivity and reproducibility compared to visual inspection methods like VIA or subjective assessments like cytology [19–23].”
From HPV Screening in Women Living with HIV (WLHIV) in Karnataka, India: Can it be Integrated into ART Centres? (2025) · cites this paper as [19]
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“No higer sensitivity was observed in the Indian trial [8] and in the RTISTIC trial [14].”
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Metaprop: a Stata command to perform meta-analysis of binomial data
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Self-citationCytology versus HPV testing for cervical cancer screening in the general population
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Self-citationAssessment of the Roche Linear Array HPV Genotyping Test within the VALGENT framework
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“These performance metrics high-light the balance between sensitivity and specificity in correlating HPV positivity to cytological pathology [19].”
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“The rationale for this choice lies in HPV testing’s high sensitivity for detecting precancerous lesions in WLHIV and its inherent advantages of objectivity and reproducibility compared to visual inspection methods like VIA or subjective assessments like cytology [19–23].”
- Authors
- Arbyn, M., Ronco, G., Anttila, A., Meijer, C. J. L. M., Poljak, M., Ogilvie, G., Koliopoulos, G., Naucler, P., Sankaranarayanan, R., & Peto, J.
- Affiliations
- Institut Scientifique de Santé Publique (BE)
- Finnish Cancer Registry (FI)
- Amsterdam UMC Location Vrije Universiteit Amsterdam (NL)
- University of Ljubljana (SI)
- BC Centre for Disease Control (CA)
- University Hospital of Ioannina (GR)
- Centre international de recherche sur le cancer (FR)
- London School of Hygiene & Tropical Medicine (GB)
- Corresponding author
- Arbyn, Marc
- ORCID
- Venue
- Vaccine
- Publisher
- Elsevier BV
- Published
- 2012-11
- Volume
- 30
- Pages
- F88-F99
- ISSN
- 0264-410X (ISSN-L)
- OpenAlex
- W2144175542
- Cited by
- 897
- References
- 1
- Citations by year
- 2026: 36 · 2025: 56 · 2024: 54 · 2023: 55 · 2022: 62 · 2021: 58 · 2020: 110 · 2019: 70 · 2018: 68 · 2017: 61 · 2016: 68 · 2015: 87 · 2014: 62 · 2013: 44 · 2012: 3
- FWCI
- 7.82
- Type
- journal article
- Language
- en
- Update notices
- erratum (2013-12-16)
- Open access
- green
- zenodo.org
- Licence
- Locations
- Vaccine (publishedVersion)
- PubMed (publishedVersion)
- Pure Amsterdam UMC (publishedVersion)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
- Ghent University Academic Bibliography (Ghent University) (submittedVersion)
- Zenodo (CERN European Organization for Nuclear Research) (submittedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Cervical Cancer and HPV Research
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Women's cancer prevention and management
- Life Sciences › Immunology and Microbiology › Microbiology › Reproductive tract infections research
- Keywords
- HPV testing, cervical cancer screening, secondary prevention, HPV triage, Hybrid Capture 2, high-risk HPV DNA testing, cervical intraepithelial neoplasia, low-grade squamous intraepithelial lesion, Pap smear, HPV 16/18
- MeSH terms
- Uterine Cervical Neoplasms, Female, Humans, Virology, Molecular Diagnostic Techniques, Papillomavirus Infections, Early Detection of Cancer, Secondary Prevention
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