Primary high-risk human papillomavirus testing for cervical cancer screening in the United States: Is it time?

Abstract

Context.-The most recent update to cervical cancer screening guidelines offers interim guidance on the use of primary human papillomavirus (HPV) screening, with algorithms for management of results. After decades of screening with pure cytology and a shorter time with adjunctive HPV or cotesting with Papanicolaou (Pap) test and HPV, this is a significant change to our screening methods. Objective.-To briefly review the history of cervical cancer screening, the evidence upon which these interim guidelines were based, the arguments for and against primary HPV testing, and the current state of the field. Data Sources.-Primary studies, review articles, and commentaries were reviewed. Conclusions.-While there is evidence both for and against primary HPV testing, there are a growing number of countries adopting the practice. It would be worthwhile to be informed and prepared for such a change in the United States as well.