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The value of human papillomavirus testing

Academic Unit of Obstetrics and Gynaecology, St Mary's Hospital, Whitworth Park, Manchester, M13 OJH, UK. email: hkitchener{at}central.cmht.nwest.nhs.uk

Exfoliative cervical cytology has endured for 50 years and has been proven to reduce deaths from cervical cancer. Despite this, it lacks sensitivity and is also labour intensive. Human papillomavirus (HPV) has been shown to be a more sensitive test for detection of underlying cervical intraepithelial neoplasia (CIN). Because HPV is a necessary event in cervical carcinogenesis HPV testing has a very high negative predictive value, which is a valuable attribute in a diagnostic test. Three settings have been investigated: triage for low-grade cervical cytology, follow-up after treatment of CIN and primary cervical screening. The evidence for HPV testing is presented and an assessment of how it may develop in the UK.

Keywords Keywords / cervical neoplaisa / human papillomavirus (HPV) / screening / testing