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Randomised controlled trial
The difference in sensitivity between HPV testing and cytology for detecting current and future CIN2+ increases over time
  1. Peter Sasieni
  1. Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
  1. Correspondence to : Professor Peter Sasieni, Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK; p.sasieni{at}qmul.ac.uk

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Context

Human papillomavirus (HPV) testing is more sensitive but less specific than cytology for detecting CIN2+.1 Longitudinally, the cumulative rate of CIN2+ 6 years after a negative HPV test is similar to the rate 3 years after negative cytology.2 However, some researchers have suggested that this improved sensitivity is due to overdiagnosis of regressive lesions.3 Meta-analysis of randomised controlled trials shows that screening with HPV testing prevents more cervical cancers than with cytology.4 There is little evidence regarding CIN2+ more than 6 years after HPV testing.

Methods

Consenting women aged 32–38 were randomised between HPV and cytology double testing (n=6257) and cytology alone (n=6270). Stored samples from the control arm were tested …

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