Human papillomavirus testing in cervical cancer screening

Research on the use of human papillomavirus (HPV) DNA testing in the screening and management (triage) of cervical lesions began in the late 1980s with the growing evidence that certain (high-risk (HR)) HPV types were the cause of cervical cancer ( Walboomers et al, 1999 ; IARC, 2005 ). Since women not infected with HR HPV types, even with abnormal cytology, are at negligible risk for cervical cancer, HPV testing could be superior to cytology in cervical cancer screening ( Cuzick et al, 1999 ; Nobbenhuis et al, 1999 ). Human papillomavirus testing may also be cost-effective if it allows for a longer screening interval, or for screening to be discontinued at an earlier age than currently recommended (i.e., 65 years). Follow-up studies of women with negative cytology, according to HPV status, are therefore important. In this issue, Bulkmans et al (2005) and Grainge et al (2005) , using two different study designs, provide further evidence of the value of adding HPV testing to cervical cytology in screening programmes.