Human Papillomavirus and Papanicolaou Tests to Screen for Cervical Cancer

This Swedish study demonstrates the value of adding a test for HPV DNA to the Pap test for cervical-cancer screening. High-grade (grade 2 or 3) CIN was found more frequently in the initial screening of women who had both tests, and the incidence of grade 3 CIN lesions was reduced in later screening of women who had both tests. High-grade cervical intraepithelial neoplasia was found more frequently in the initial screening of women who had both HPV DNA and Pap tests, and the incidence of grade 3 lesions was reduced in later screening of women who had both tests. Screening for cervical cancer by cytologic examination (the Papanicolaou [Pap] test) has reduced the incidence of invasive cervical cancer in many countries, 1 , 2 yet cervical cancer remains a leading cause of death and illness in women. 2 Human papillomavirus (HPV) is the major cause of cervical cancer, and in the natural history of the disease, persistent HPV infection precedes the appearance of cytologic abnormalities. 3 , 4 Longitudinal cohort studies have shown that combined Pap and HPV testing has better sensitivity and provides better long-term protection (among women with normal results of both tests) against grade 3 cervical intraepithelial neoplasia than does cytologic . . .