There are limits in using cytology as a primary screening test. New strategies are needed.
Up to one-third of cervical cancers occur in screened women with normal Pap cytology.1,2
Liquid-based cytology (LBC) screening has been useful in significantly reducing the incidence and mortality rate of cervical cancer.3 Despite having high specificity, cytology has lower sensitivity than HPV testing, resulting in missed disease in patients, including cases of high-grade disease.1,2,4
Evidence supports moving to hrHPV testing for primary screening of cervical cancer.5
CINtec® PLUS Kit enhances sensitivity in cytology-based screening.
CINtec® Histology Kit significantly improves diagnostic accuracy.10
1. Leyden WA, Manos MM, Geiger AM, et al. Cervical cancer in women with comprehensive health care access: attributable factors in the screening process. J Natl Cancer Inst. 2005;97:675-683.
2. Andrae B, Kemetli L, Sparén P, et al. Screening-preventable cervical cancer risks: evidence from a nationwide audit in Sweden. J Natl Cancer Inst. 2008;100:622-629.
3. Saslow D, Solomon D. Lawson HW, et al. American Cancer Society, American Society for Colposcopy and Cervical Pathology, and American Society for Clinical Pathology screening guidelines for the prevention and early detection of cervical cancer. Am J Clin Pathol. 2012; 137:516-542.
4. Whitlock EP, Vesco KK, Eder M, Lin JS, Senger CA, Burda BU. Liquid-based cytology and human papillomavirus testing to screen for cervical cancer: a systematic review for the U.S. Preventative Services Task Force. Ann Intern Med. 2011; 155:687-697.
5. Rijkaart DC, Berkhof J, Rozendaal L, et al. Human papillomavirus testing for the detection for high-grade cervical intraepithelial neoplasia and cancer: final results of the POBASCAM randomized controlled trial. Lancet Oncol. 2012; 13:78-88.
6. Cox JT, Castle PE, Behrens CM, et al. Comparison of cervical cancer screening strategies incorporating different combinations of cytology, HPV testing and genotyping for HPV 16/18: results from ATHENA HPV study. Am J Ob Gyn. 2012:in Press.
7. Wright T.C., Stoler M, Sharma A, Zhang G, Behrens C, Wright T.L., ATHENA Study Group. Evaluation of HPV-16 and HPV-18 genotyping for the triage of women with high-risk HPV+ cytology-negative results. Am J Clin Pathol. 2011;136:578-586.
8. Petry KU, Schmidt D, Scherbring S, et al. Triaging Pap cytology negative, HPV positive cervical cancer screening results with p16/Ki-67 dual-stained cytology. Gynecol Oncol. 2011;121(3):505-509.
9. Wentzensen N, Schwartz L, Zuna R.E., et al. Performance of p16/Ki-67 Immunostaining to Detect Cervical Cancer Precursors in a Colposcopy Referral Population. Clin Cancer Res 2012;18:4154-4162. Published Online First on June 6, 2012.
10. Bergeron C, Ordi J, Schmidt D, Trunk MJ, Keller T, Ridder R, European CINtec Histology Study Group. Conjunctive p16INK4a testing significantly increases accuracy in diagnosing high-grade cervical intraepithelial neoplasia. Am J Clin Pathol. 2010;133(3):395-406.