HPV testing plus liquid-based cytology screening 'no more effective'

By Ashleigh Goff

Adding in HPV testing to liquid-based cytology for cervical screening makes screening no more effective, according to data from the first randomised controlled trial into the combination.

The current screening programme in the UK uses only LBC and prevents around 70% of cancers, but there have been suggestions adding in HPV testing could make the screen more accurate.

A team at the University of Manchester studied 24,510 women aged 20–64 who participated in two rounds of screening, three years apart. All were given the combination of LBC and HPV testing but the HPV result was known and acted on in one group but concealed until the end of the study in the other.

Researchers found no significant difference in the proportion of women with CIN2 or CIN3 lesions. The study is published in the latest issue of The Lancet Oncology.

Lead researcher Professor Henry Kitchener, chair of gynaecological oncology at the University of Manchester said: ‘Over two rounds of screening this trial showed no evidence that LBC combined with HPV testing in primary cervical screening detected more CIN2 or CIN3 than cytology alone.'.

But Professor Jack Cuzick, director of the Cancer Research UK centre for epidemiology at the Wolfson Institute of Preventive Medicine in London, who is conducting a similar primary care-based trial, said: ‘I think this study has some major issues. About another dozen studies show HPV results are better, and all other literature contradicts the results of this study.'

The Manchester trial will continue for a further three years to find out if HPV testing can extend screening intervals.