Role of Human Papillomavirus Testing in Screening of Cervical Neoplasia

Human papillomavirus (HPV) is the causative agent of cervical intraepithelial neoplasia and cervical cancer. HPV and cytology co-tests in women aged 30 years or older every 5 years as primary cervical screening is recommended for developed countries. In HPV-positive and cytology-negative women, follow-up with co-tests at 12 months is recommended. Nevertheless, if HPV-16 or HPV-18 is positive, direct colposcopy is recommended. In mild cytological abnormality and HPV-negative women, routine screening should be continued as per age-specific guidelines. Women with history of cervical intraepithelial neoplasia grade 2 or more should be followed at least 20 years even after age 65 years. In area with very limited resource, a single visit “screen-and-treat” visual inspection with acetic acid might be reasonable. Although the policies of cervical screening vary in different regions, the future screening strategies when the young HPV vaccinated population reaches the screening age will need to be renovated.