The Clinical Role of HPV Testing in Primary and Secondary Cervical Cancer Screening
Table 1
Summary of recommendations that reflect the best evidence-based practice for the prevention of CC morbidity and mortality through currently available screening tests that maximize protection against CC while minimizing the potential harms associated with false-positive results and overtreatment.
Recommended screening methoda
Management of screen results
Comments
No screening
HPV testing should not be used for screening or management of ASC-US in this age group
Cytology alone every 3 y
HPV-positive ASC-USb or cytology of LSIL or more severe: refer to ASCCP guidelines
HPV testing should not be used for screening in this age group
Cytology negative or HPV-negative ASC-USb: rescreen with cytology in 3 y
HPV-positive ASC-US or cytology of LSIL or more severe: refer to ASCCP guidelines2
HPV and cytology “cotesting” every 5 y (preferred)
HPV positive, cytology negative: Option 1: 12-mo followup with cotesting Option 2: Test for HPV 16 or HPV 16/18 genotypes (i) if HPV 16 or HPV 16/18 positive: refer to colposcopy (ii) if HPV 16 or HPV 16/18 negative: 12-mo followup with cotesting
Screening by HPV testing alone is not recommended for most clinical settings
Cotest negative or HPV-negative ASC-US: rescreen with cotesting in 5 y
Cytology alone every 3 y (acceptable)
HPV-positive ASC-USb or cytology of LSIL or more severe: refer to ASCCP guidelines2
Cytology negative or HPV-negative ASC-USb: rescreen with cytology in 3 y
No screening following adequate negative prior screening
Women with a history of CIN2 or a more severe diagnosis should continue routine screening for at least 20 y
No screening
Applies to women without a cervix and without a history of CIN2 or a more severe diagnosis in the past 20 y or cervical cancer ever
Follow age-specific recommendations (same as unvaccinated women)
aWomen should not be screened annually at any age by any method. bASC-US cytology with secondary HPV testing for management decisions [10].
