Practice-Based Evidence for Primary HPV Testing in the United States
Menée à partir de modèles mathématiques incorporant des données portant sur 1 011 092 femmes dont le test HPV ou Pap s'est révélé négatif (âge : de 30 à 64 ans), cette étude américaine évalue, en fonction de trois stratégies de dépistage, le risque à 3 ans de cancer ou de néoplasie intraépithéliale de grade supérieur ou égal à 3 du col utérin
ince the US Food and Drug Administration (FDA) approval of the first human papillomavirus (HPV) test for primary cervical cancer screening in April, questions regarding if and how to integrate HPV testing alone into routine practice have come to the fore. Although already approved and used widely in practice either as a triage test for equivocal Pap results or in combination with Pap (“cotesting”) in women aged 30 years and older, HPV testing used alone for primary screening offers a new option in the long tradition of Pap testing, which has contributed to the dramatic decline of cervical cancer incidence and mortality but is not without limitations (1). In this issue of the Journal, Gage et al. (2) provide timely evidence from the United States that HPV primary testing can provide equal or more reassurance against cancer risk than strategies currently recommended by guidelines (3,4). Using data from Kaiser Permanente Northern California (KPNC), which has been routinely screening women aged 30–64 years with cotesting at roughly three-year intervals since 2003, the authors took advantage of the unique opportunity to make head-to-head comparisons among Pap testing, HPV testing, and cotesting. They found that an HPV-negative result confers lower cumulative risks of precancer and cancer within three years, an interval being considered for HPV primary testing, than a Pap-negative result within three years and a cotest-negative (concurrent Pap-negative and HPV-negative) result within five …
Journal of the National Cancer Institute , éditorial, 2014