HPV test detects cervical pre-cancer earlier, more accurately than Pap smear

Primary HPV testing is more effective in women undergoing cervical cancer screening

Cervical intraepithelial neoplasia (CIN) is a precancerous condition in which abnormal cells grow on the surface of the cervix. CIN 3 (the most severe form) is a condition that affects more than two-thirds of the lining tissue.

Human papillomavirus is the most common sexually transmitted disease worldwide, affecting 50%-75% of sexually active people. The HPV4 vaccine is effective at protecting against 90% of the strains that cause cervical and anal cancer.

A randomized clinical trial that included 19 009 women found screening with primary HPV testing was more effective. It resulted in significantly lower likelihood of CIN3+ at 48 months compared with cytology tests (2.3/1000 vs 5.5/1000).

In this trial, women screened for cervical cancer with HPV testing without cytology developed significantly fewer CIN3+ and CIN2+ cases compared with women who were screened with cytology alone at baseline at 48 months. Women who were HPV negative at baseline were significantly less likely to have CIN3+ and CIN2+ at 48 months compared with women who were cytology negative at baseline. These results have demonstrated that primary HPV testing detects cervical neoplasia earlier and more accurately than cytology.

Nearly 99,099 estimated cervical cancer cases and 66,552 deaths due to cervical cancer occur annually. At any given point of time, nearly 4,18,175 cervical cancer cases are present in India

Approximately 99.7% of all cervical cancers are associated with a chronic cervical infection with an oncogenic human papillomavirus (HPV) genotype. Although HPV vaccination holds potential as an effective cancer control strategy, given current vaccine uptake rates and costs, secondary prevention through screening will need to continue in the coming decades and advances in improving screening remain a key priority for women’s health.

As per the population based cancer registries reports, globally, cervical cancer is the 4th most common cancer in women. In India, cervical cancer is the 2nd most common cancer in women and the country contributes to largest proportion of global cervical cancer burden. Nearly 99,099 estimated cervical cancer cases and 66,552 deaths due to cervical cancer occur annually. At any given point of time, nearly 4,18,175 cervical cancer cases are present in country. In India the highest technical body for vaccination has already cleared HPV vaccine for inclusion in the universal immunisation programme. However discordant voices continue to be heard questioning both the safety and efficacy of the vaccine.