Page 35 - Screening for Cervical Cancer: Systematic Evidence Review
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Chapter II. Methods
Key Question 3: What is the Role of HPV Testing?
After consultation within our team and with the USPSTF in a February 2000 conference
call, we restricted this portion of the review to recent literature. Although the previous Guide to
Clinical Preventive Services recommended against use of HPV testing as an ancillary test within
a screening strategy, we believed that the laboratory technology for HPV identification,
classification, and measurement of viral DNA incorporation has changed so rapidly that a review
of the recent literature was appropriate.
Our search identified 64 abstracts potentially relevant to this topic; once again the
individual review of all abstracts identified more articles for full review than restriction of search
#8 in Table 4 using a variety of electronic search strategies. In total, we screened 30 full articles
to determine relevance. The strict inclusion criteria for assessing screening studies were applied
to the HPV literature. Studies on this topic were more likely to include histologic verification of
test results, although no prospective comparisons of individual patient outcomes or published
randomized trials examine the efficacy or effectiveness of HPV testing in clinical use. Overall,
16 of these 30 articles were included for this question, 13 for full abstraction and 3 for
supplementary information.
Cost and Harms
The screening worksheet for each key question included additional questions to identify
articles that reported on cost, cost-effectiveness, and harms, including psychological distress.
When we flagged an article as potentially providing background on cost, cost-effectiveness, or
other relevant economic evaluations, we subjected the article to further review by another team
member.
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