Human Papillomavirus DNA versus Papanicolaou Screening Tests for Cervical Cancer

This randomized, controlled trial involving more than 10,000 Canadian women investigated Papanicolaou (Pap) cytologic testing and human papillomavirus (HPV) DNA testing in screening for high-grade cervical intraepithelial neoplasia (CIN). All women received both tests. Biopsies, colposcopies, and excisional procedures were performed when indicated. The HPV test was found to be more sensitive than the Pap test. This trial investigated Pap testing and HPV DNA testing to screen for high-grade cervical intraepithelial neoplasia. The HPV test was found to be more sensitive than the Pap test. Cervical cancer remains the second most common cancer in women worldwide, 1 even though screening with cervical cytologic testing (the Papanicolaou [Pap] test) has been available for over 50 years. In resource-rich countries, there was a decrease in the incidence of cervical cancer after the introduction of Pap testing. This decrease has recently leveled off, and frequent retesting is required to achieve an acceptable sensitivity because of the low sensitivity of the Pap test. 2 Testing cervical specimens for DNA of oncogenic (high-risk) types of human papillomavirus (HPV), the causal agents of cervical cancer, has entered clinical practice, but this test is . . .