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Cervical cancer—should we abandon cytology for screening?

Nature Reviews Clinical Oncology volume 9, pages 558559 (2012) | Download Citation

Convincing data have shown that human papillomavirus (HPV)-DNA testing predicts the development of high-grade cervical cancer better than cytology. However, for HPV-positive women, triage with cytology testing should be performed before colposcopy. The question on how to proceed if the cytology test in HPV-positive women is negative remains unclear.

Key points

  • Cervical cancer screening should be done by HPV-DNA testing alone

  • Cytology or cytology with HPV 16 and HPV18 genotyping can be used to triage HPV-positive women for colposcopy

  • The exact algorithm to be used for triage depends on the quality of cytology and the minimum positive predictive value for CIN3+ referral acceptable by local health decision makers

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Author information


  1. Departments of Pathology and Epidemiology and Biostatistics, Vrije Universiteit, University Medical Center, PO Box 7057, 1007 MB Amsterdam, The Netherlands

    • Chris J. L. M. Meijer
    •  & Johannes Berkhof


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Competing interests

C. J. L. M. Meijer has acted as consultant for Qiagen, GlaxoSmithKline and Merck; has received honoraria from Qiagen and Roche; has received research support from Abbott; is a stockholder in Self-Screen; and holds a patent with MDxHealth. J. Berkhof has received honoraria from Qiagen.

Corresponding author

Correspondence to Chris J. L. M. Meijer.

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