Cervical Cancer Screening: The Transformational Role of Routine Human Papillomavirus Testing
Authors: Guglielmo Ronco, Silvia Franceschi
Journal: Annals of Internal Medicine (2017)

Editorials2 January 2018Cervical Cancer Screening: The Transformational Role of Routine Human Papillomavirus TestingGuglielmo Ronco, MD, PhD and Silvia Franceschi, MD, PhDGuglielmo Ronco, MD, PhDCity of Health and Science, Turin, Italy (G.R.)Search for more papers by this author and Silvia Franceschi, MD, PhDInternational Agency for Research on Cancer, Lyon, France (S.F.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M17-2872 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail 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 ...References1. Naucler P, Ryd W, Törnberg S, Strand A, Wadell G, Elfgren K, et al. Human papillomavirus and Papanicolaou tests to screen for cervical cancer. N Engl J Med. 2007;357:1589-97. [PMID: 17942872] CrossrefMedlineGoogle Scholar2. Rijkaart DC, Berkhof J, Rozendaal L, van Kemenade FJ, Bulkmans NW, Heideman DA, et al. Human papillomavirus testing for the detection of high-grade cervical intraepithelial neoplasia and cancer: final results of the POBASCAM randomised controlled trial. Lancet Oncol. 2012;13:78-88. [PMID: 22177579] doi:10.1016/S1470-2045(11)70296-0 CrossrefMedlineGoogle Scholar3. Ronco G, Giorgi-Rossi P, Carozzi F, Confortini M, Dalla Palma P, Del Mistro A, et al; New Technologies for Cervical Cancer screening (NTCC) Working Group. Efficacy of human papillomavirus testing for the detection of invasive cervical cancers and cervical intraepithelial neoplasia: a randomised controlled trial. Lancet Oncol. 2010;11:249-57. [PMID: 20089449] doi:10.1016/S1470-2045(09)70360-2 CrossrefMedlineGoogle Scholar4. Kitchener HC, Almonte M, Thomson C, Wheeler P, Sargent A, Stoykova B, et al. HPV testing in combination with liquid-based cytology in primary cervical screening (ARTISTIC): a randomised controlled trial. Lancet Oncol. 2009;10:672-82. [PMID: 19540162] doi:10.1016/S1470-2045(09)70156-1 CrossrefMedlineGoogle Scholar5. Ronco G, Dillner J, Elfström KM, Tunesi S, Snijders PJ, Arbyn M, et al; International HPV screening working group. Efficacy of HPV-based screening for prevention of invasive cervical cancer: follow-up of four European randomised controlled trials. Lancet. 2014;383:524-32. [PMID: 24192252] doi:10.1016/S0140-6736(13)62218-7 CrossrefMedlineGoogle Scholar6. Castle PE, Kinney WK, Xue X, Cheung LC, Gage JC, Zhao FH, et al. Effect of several negative rounds of human papillomavirus and cytology co-testing on safety against cervical cancer. An observational cohort study. Ann Intern Med. 2018;168:20-9. doi:10.7326/M17-1609 LinkGoogle Scholar7. McCredie MR, Sharples KJ, Paul C, Baranyai J, Medley G, Jones RW, et al. Natural history of cervical neoplasia and risk of invasive cancer in women with cervical intraepithelial neoplasia 3: a retrospective cohort study. Lancet Oncol. 2008;9:425-34. [PMID: 18407790] doi:10.1016/S1470-2045(08)70103-7 CrossrefMedlineGoogle Scholar8. Walboomers JM, Jacobs MV, Manos MM, Bosch FX, Kummer JA, Shah KV, et al. Human papillomavirus is a necessary cause of invasive cervical cancer worldwide. J Pathol. 1999;189:12-9. [PMID: 10451482] CrossrefMedlineGoogle Scholar9. Arbyn M, Ronco G, Anttila A, Meijer CJ, Poljak M, Ogilvie G, et al. Evidence regarding human papillomavirus testing in secondary prevention of cervical cancer. Vaccine. 2012;30 Suppl 5:F88-99. [PMID: 23199969] doi:10.1016/j.vaccine.2012.06.095 CrossrefMedlineGoogle Scholar10. Ronco G, Segnan N, Giorgi-Rossi P, Zappa M, Casadei GP, Carozzi F, et al; New Technologies for Cervical Cancer Working Group. Human papillomavirus testing and liquid-based cytology: results at recruitment from the new technologies for cervical cancer randomized controlled trial. J Natl Cancer Inst. 2006;98:765-74. [PMID: 16757701] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: City of Health and Science, Turin, Italy (G.R.)International Agency for Research on Cancer, Lyon, France (S.F.)Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M17-2872.Corresponding Author: Guglielmo Ronco, MD, PhD, Via Cavour 31, 10123 Turin, Italy; e-mail, guglielmo.[email protected]it.Current Author Addresses: Dr. Ronco: Via Cavour 31, 10123 Turin, Italy.Dr. Franceschi: International Agency for Research on Cancer, 150 Cours Albert Thomas, 69008 Lyon, France.This article was published at Annals.org on 28 November 2017. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoEffect of Several Negative Rounds of Human Papillomavirus and Cytology Co-testing on Safety Against Cervical Cancer Philip E. Castle , Walter K. Kinney , Xiaonan Xue , Li C. Cheung , Julia C. Gage , Fang-Hui Zhao , Barbara Fetterman , Nancy E. Poitras , Thomas S. Lorey , Nicolas Wentzensen , Hormuzd A. Katki , and Mark Schiffman Metrics Cited byOverexpression of SMC4 predicts a poor prognosis in cervical cancer and facilitates cancer cell malignancy phenotype by activating NF-κB pathwayDown-regulation of lncRNA PCGEM1 inhibits cervical carcinoma by modulating the miR-642a-5p/LGMN axisPrimary HPV testing with cytology versus cytology alone in cervical screening—A prospective randomized controlled trial with two rounds of screening in a Chinese population Long Non-Coding RNA-NEAT1 Promotes Cell Migration and Invasion via Regulating miR-124/NF-κB Pathway in Cervical Cancer 2 January 2018Volume 168, Issue 1Page: 75-76KeywordsCancer screeningCell biologyCervical cancerCervical cancer screeningCervical intraepithelial neoplasiaHuman papillomavirusLesionsObservational studiesRandomized trialsTriage ePublished: 28 November 2017 Issue Published: 2 January 2018 Copyright & PermissionsCopyright © 2017 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...