Cervical cancer screening : The transformational role of routine human papillomavirus testing
Menée aux Etats-Unis à partir de données portant sur 990 013 femmes dont les résultats d'un ou plusieurs tests de dépistage du cancer du col utérin se sont avérés négatifs, cette étude évalue, en fonction du nombre de co-tests négatifs à trois ans d'intervalle (test HPV et analyse cytologique), le risque de lésions cervicales intraépithéliales de grade 3, d'adénocarcinome in situ ou de cancer du col utérin à 3 et 5 ans
Human papillomavirus (HPV)–based screening enables earlier detection of persistent high-grade cervical intraepithelial neoplasia (CIN) (1–4) and provides greater protection against invasive cervical cancer than cytology-based screening (5). However, most of our knowledge about HPV-based screening comes from studies of women having only 1 round of HPV testing. In fact, the gain in protection from invasive cervical cancer estimated by the pooled analysis of randomized trials (5) substantially reflects that obtained by a single round of HPV screening. Therefore, Castle and colleagues (6) deserve praise for providing essential new information on how cancer risk changed following repeated rounds of HPV testing in a cohort of nearly 1 million women screened by Hybrid Capture 2 (Qiagen) and cytology co-testing every 3 years, 79 946 of whom had more than 3 co-tests (6).
Annals of Internal Medicine , éditorial, 2016