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HPV 'cost-effective' for borderline smears

Triaging women with borderline cervical smear results using human papillomavirus testing would be feasible and cost-effective, researchers conclude.

The NHS research, published online by the BMJ as two separate studies, is likely to intensify the debate over whether HPV testing should be added into the cervical screening programme.

Researchers assessed a number of different strategies using HPV testing to decide which women with borderline or mildly dyskaryotic smear results should be sent for colposcopy.

One of the studies found using HPV testing in conjunction with liquid-based cytology saved slightly more lives, was cost-effective and cut the number of lifetime smears by between 52 and 86 per cent.

But there was a sharp increase in the number of colposcopies of between 64 and 134 per cent, a finding the researchers said was 'of concern'.

Dr Sue Moss, leader of both studies and associate director at the Cancer Screening Evaluation Unit in Surrey, said: '[We need to know] whether you can develop strategies that reduce the negative effects of colposcopy. We just need to be careful.'

But Professor Jack Cuzick, head of the Centre for Epidemiology, Mathematics and Statistics at Cancer Research UK, said there was now an 'overwhelming' case for using HPV testing in conjunction with liquid-based cytology.

'There are a couple of logitical issues in that if you do HPV for borderline smears any single lab would struggle with the extra work, but we should be doing HPV testing immediately.'

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