HPV test shows low sensitivity of Pap screen in older women.

摘要

In the March, 2010, issue of The Lancet Oncology, Ronco and colleagues1 noted that human papillomavirus-based (HPV) screening is more effective than cytology in preventing invasive cervical cancer, and that screening can lead to over diagnosis of regressive grade 2 cervical intraepithelial neoplasia (CIN) in younger women. HPV-positive women were divided by age into two groups (25-34 and 35-60 years) at recruitment.We believe that the advantages of HPV testing in postmenopausal women are even more pronounced than when using an age span of 35-60 years. Efficacy of cytological screening is known to be lower in higher age groups, and is only effective in 20% of women aged 50 years or older, compared with women aged 30-35 years old.2 In 2006, over 60% of patients with cervical squamous carcinoma in Sweden occurred in postmenopausal women, aged 50 years or older.3 Only 9% of grade 2 and 3 CIN biopsy diagnoses in Uppsala County were noted in women aged 50 years or older.