For women over 30, HPV testing should be the first choice for cervical cancer screening

An HPV test costs between 100 and 300 yuan. Women with a negative result can get tested again only once every five years. The sampling process takes just a few minutes.

That trial in rural India used cluster randomization rather than individual randomization. The subjects were women aged 30 to 59. By undergoing only a single HPV screening test, the risk of dying from cervical cancer is reduced by approximately 48%. The original value HR 0.52, 95% CI 0.33 to 0.83. The risk of detecting advanced cervical cancer is reduced by approximately 53% (HR 0.47, 95% CI 0.32 to 0.69). Regarding testing intervals, refer to the 2018 recommendations from the US Preventive Services Task Force: for women aged 30 to 65 undergoing HPV testing for high-risk types alone, testing should be performed once every 5 years.

Sankaranarayanan R 等 (2009). HPV screening for cervical cancer in rural India. New England Journal of Medicine. https://doi.org/10.1056/NEJMoa0808516；US Preventive Services Task Force (2018). Cervical Cancer: Screening：「For women aged 30 to 65 years, the USPSTF recommends screening every 3 years with cervical cytology alone, every 5 years with high-risk human papillomavirus (hrHPV) testing alone, or every 5 years with hrHPV testing in combination with cytology (cotesting).」https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/cervical-cancer-screening

Even women who have received the HPV vaccine still need screening, since the vaccine does not protect against all viral types. What makes this study unique is that it was a randomized screening trial with mortality as the primary outcome and only one round of testing performed.