Page 58 - Screening for Cervical Cancer: Systematic Evidence Review

Chapter III. Results

relate the findings at screening to outcomes, the linkages between comparative test performance

are insufficient to judge the implications of preferentially using one system over another.

Key Question 3: Role of HPV Testing in Cervical Cancer
Screening

We examined two potential roles for HPV testing in cervical cancer screening. The first

is focused on screening use of HPV testing, including simultaneous use with Pap testing. The

second envisions a role for HPV in triaging women with abnormal screening Pap results with an

emphasis on when knowledge of HPV status might modify decision-making about the need for

or extent of further evaluation. Our specific questions were:

3A. Screening Use of HPV Testing: What are the benefits, harms, and costs of using

HPV testing as a screening test, or of incorporating HPV testing at the time of the

screening Pap test compared with not testing for HPV?

3.B. Triage Use of HPV Testing: What are the benefits, harms, and costs of using HPV

testing as part of a screening strategy to determine which women with an abnormal Pap

test should receive further evaluation?

We reviewed 30 potentially relevant publications. Ultimately, we abstracted 13 of these

and entered their data into Evidence Tables 3A and 3B; we retained another three articles for

background. The systematic review of the role of HPV testing in cervical cancer screening

prepared by Cuzick and colleagues for the UK Health Technology Assessment Board of the

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National Health Service was a valuable aid. Their publication influenced our decisionmaking

about which testing modalities to consider appropriate for screening use, and it validated the

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