Limited benefit for routine cervical cancer screening with co-testing versus HPV testing alone

Clinical Question

Is detection of high-grade cervical neoplasia superior with co-testing or with primary HPV testing only?

Bottom line

The results of this population-based retrospective Swedish cohort support HPV testing alone as a routine screening approach for cervical cancer. Among individuals confirmed by biopsy to have CIN2+, cytology was positive in < 0.02% of individuals with negative HPV. These results didn’t hold for testing based on clinical indications or for unknown indication, in which 3.8% of individuals with CIN2+ would have been missed without cytology as a co-test. 2b

Study design: Cohort (retrospective)

Funding: Government

Setting: Population-based


Linda Speer, MD
Professor and Chair, Department of Family Medicine
University of Toledo
Toledo, OH

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