Management of women who test positive for high-risk types of human papillomavirus: The HART study

J. Cuzick, A. Szarewski, H. Cubie, G. Hulman, H. Kitchener, D. Luesley, E. McGoogan, U. Menon, G. Terry, R. Edwards, C. Brooks, M. Desai, C. Gie, L. Ho, I. Jacobs, C. Pickles, P. Sasieni

    Research output: Contribution to journalArticlepeer-review

    Abstract

    Background: Certain types of human papillomavirus (HPV) are the primary cause of almost all cervical cancers. HPV testing of cervical smears is more sensitive but less specific than cytology for detecting high-grade cervical intraepithelial neoplasia (CIN2+). HPV testing as a primary screening approach requires efficient management of HPV-positive women with negative or borderline cytology. We aimed to compare the detection rate and positive predictive values of HPV assay with cytology and to determine the best management strategy for HPV-positive women. Methods: We did a multicentre screening study of 11 085 women aged 30-60 years. Women with borderline cytology and women positive for high-risk HPV with negative cytology were randomised to immediate colposcopy or to surveillance by repeat HPV testing, cytology, and colposcopy at 12 months. Findings: HPV testing was more sensitive than borderline or worse cytology (97.1% vs 76.6%, p=0.002) but less specific (93.3% vs 95.8%, p
    Original languageEnglish
    Pages (from-to)1871-1876
    Number of pages5
    JournalThe Lancet
    Volume362
    Issue number9399
    DOIs
    Publication statusPublished - 6 Dec 2003

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