Cervical cancer screening, HPV test, Cytology


Cervical cytology has been considered a reliable test for the detection of precancerous lesions and cancer for decades. Cytology-based screening has been considered a reliable test for the detection of cervical precancerous lesions and cancer for decades. Over the past decade, several randomized trials have shown HPV tests as a test with higher sensitivity and accuracy in the diagnosis of cervical lesions. The latest European and US guidelines call for screening using an HPV test that would allow us to be more accurate in the detection of cervical precancer and cancer, as well as increase the screening interval in case of a negative result. The study aimed to compare the advantages and disadvantages of cytology and HPV-based screening. Data were obtained from peer-reviewed literature, national recommendations, and practice guidelines. According to the mentioned literature review, it was determined that the positive achievements of HPV primary screening, compared to cytological screening, can be considered: higher sensitivity to detect cervical squamous and glandular precancerous lesions, and finally reduction in cervical cancer incidence. The potential harm of primary HPV screening includes increased positive test results, referral to colposcopy, and the number of biopsies, as well as excessive detection of non-progressive CIN2+ lesions. These risks are especially pronounced in young women. The potential harm of HPV primary screening can be significantly reduced or avoided by implementing an appropriate screening policy adjusting the age range, and using cytological triage.


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