18Evidence A

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

In that rural Indian trial, women who underwent just one HPV test in their lifetime had roughly half the risk of dying from cervical cancer and about 50% lower odds of being diagnosed with advanced-stage disease. At a cost of just 100–200 yuan per test, a negative result provides protection for five years.

Cost

An HPV test costs between 100 and 300 yuan. Women with a n…

Benefit

This trial in rural India used group-level rather than individual randomization, involving women aged 30–59. A…

Cost

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.

Benefit

This trial in rural India used group-level rather than individual randomization, involving women aged 30–59. A single HPV test cut the risk of death from cervical cancer by roughly 48% (hazard ratio 0.52; 95% CI 0.33–0.83). It also reduced the likelihood of detecting late-stage disease by about 53% (HR 0.47; 95% CI 0.32–0.69).

Original sources

Sankaranarayanan R 等 (2009). HPV screening for cervical cancer in rural India. New England Journal of Medicine. https://doi.org/10.1056/NEJMoa0808516

Open source link
Book note

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.

My note