Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, DK-1014 Copenhagen K, Denmark.
Curr Pharm Des. 2013;19(8):1439-49.
Human Papillomavirus (HPV) testing has been extensively studied in randomized controlled trials of primary cervical screening. Based on encouraging results concerning its high detection rates and a high negative predictive value for high-grade cervical intraepithelial neoplasia (CIN), HPV testing will probably replace cytology in future primary cervical screening. However, HPV testing is associated with more frequent false-positive tests compared to cytology. False-positive tests are defined as positive screening tests which are not subsequently confirmed with high-grade CIN. Several authors have claimed that the frequency of false-positive HPV tests could be reduced if an additional test was used to decide on referral for colposcopy of HPV-positive women. Data from the trials, however, do not support this claim. In fact, when compared to standard cytology screening and triage procedures, HPV testing leads to more screen-positive women being referred for colposcopy without having high-grade CIN, and to more women undergoing repeated testing. The only reasonable solution to the problem of false-positive tests appears to be a revised definition of a positive HPV screening test. However, further studies are needed to determine how this definition could be revised while at the same time keeping the high negative predictive value of HPV testing.
人乳头瘤病毒（HPV）检测已在原发性宫颈癌筛查的随机对照试验中得到广泛研究。基于其高检出率和对高级别宫颈上皮内瘤变（CIN）的高阴性预测值的令人鼓舞的结果，HPV 检测可能会在未来的原发性宫颈癌筛查中取代细胞学检查。然而，与细胞学检查相比，HPV 检测与更多的假阳性检测相关。假阳性检测被定义为随后未被高级别 CIN 证实的阳性筛查检测。一些作者声称，如果使用额外的检测来决定对 HPV 阳性女性进行阴道镜检查，那么假阳性 HPV 检测的频率可以降低。然而，试验数据并不支持这一说法。事实上，与标准细胞学筛查和分流程序相比，HPV 检测导致更多的筛查阳性女性被转诊进行阴道镜检查，而没有高级别 CIN，并且更多的女性进行了重复检测。解决假阳性检测问题的唯一合理方法似乎是修订 HPV 筛查检测阳性的定义。然而，需要进一步的研究来确定如何在保持 HPV 检测高阴性预测值的同时修订该定义。
