Department of Laboratory Medicine, Karolinska Institutet, Center for Cervical Cancer Prevention, Karolinska Hospital, Stockholm, Sweden.
Curr Opin Obstet Gynecol. 2013 Feb;25(1):11-6. doi: 10.1097/GCO.0b013e32835c5d10.
An update on the use of human papillomavirus (HPV) testing as the primary screening test for advancing the effectiveness of organized cervical screening programs.
Because HPV-based cervical screening has a protective effect of longer duration than cervical cytology, screening intervals can be lengthened for HPV-negative women. Under most scenarios of HPV test price and HPV prevalence, primary HPV screening is more cost-effective than primary screening with cytology. If cytology is used to triage HPV-positive women, colposcopy referral rates are not increased. However, there are logistical challenges to implement HPV-based screening, such as the need to ensure that HPV tests are used at increased screening intervals and in the correct age groups, the need to cope with the variety of different HPV tests, the limited international standardization and quality assurance, and the need to optimize and evaluate the method switch in the real-life setting.
The necessary infrastructure to exploit the potential of HPV-based screening for improved cost-efficiency exists within organized, invitational screening programs. Piloting of HPV screening can be implemented by such programs, preferably as randomized healthcare policies.
介绍人乳头瘤病毒（HPV）检测作为主要筛查试验在提高有组织的宫颈癌筛查计划效果方面的应用进展。
由于 HPV 为基础的宫颈癌筛查比宫颈细胞学具有更长的保护作用，因此可以延长 HPV 阴性女性的筛查间隔。在大多数 HPV 检测价格和 HPV 流行率的情况下，HPV 初筛比细胞学初筛更具成本效益。如果细胞学用于 HPV 阳性女性的分流，阴道镜转诊率不会增加。然而，实施 HPV 筛查存在一些实际操作上的挑战，例如需要确保 HPV 检测在增加的筛查间隔和正确的年龄组中使用，需要应对各种不同的 HPV 检测方法，国际标准化和质量保证的局限性，以及需要优化和评估实际环境中的方法转换。
有组织的邀请式筛查计划中已经存在利用 HPV 筛查提高成本效益的必要基础结构。此类计划可以试行 HPV 筛查，最好作为随机医疗保健政策。
