engleski

HPV DNA testing for cervical cancer screening

In Europe, cervical cancer is the 7th most common cause of cancer deaths in women with almost 50, 000 new cases and 22, 000 deaths per year. Screening of cervical cancer based on the cervical cytology (Papanicolau – Pap smear) has been undertaken since the 1950s and therefore saved hundred thousands lives. However, cervical cancer still remains an important health problem, especially in countries where only opportunistic screening is undertaken. In countries where an organised screening programme has been in place for decades, cervical cancer rates were reduced by 80%. Although cervical cancer screening showed to be an excellent test, it has limitations for it application on large-scale population. On the other hand, detection of the cause of cervical cancer, the high-risk (oncogenic) types of the Human papillomaviruses (HPV) has obvious advantages. The HPV DNA test identifies women at risk for developing cervical cancer. Nowadays, HPV DNA testing is widely used as secondary test for triage to borderline cytology and after treatment of severe cervical lesions. The use of HPV DNA testing for primary cervical cancer screening, either alone or in combination with the Pap test, has been evaluated in several large-scale randomised controlled trials. Although less specific than Pap spear, HPV DNA testing for primary screening showed to be substantially more sensitive in detecting severe cervical lesions. The high negative predictive value of the HPV DNA test is it major advantage as it allows increasing the screening interval. These facts support the use of HPV testing as the sole primary screening test, with cytology reserved for women who test HPV positive. Moreover, as HPV DNA testing is less time consuming, more reproducible, can be automated and requires less skills than Pap testing, the implementation of HPV DNA testing as primary screening test within organised screening programmes would be more cost-effective and more successful approach for cervical cancer control.

cervical cancer; prevention

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