TY - JOUR T1 - The difference in sensitivity between HPV testing and cytology for detecting current and future CIN2+ increases over time JF - Evidence Based Medicine JO - Evid Based Med DO - 10.1136/eb-2014-101757 SP - ebmed-2014-101757 AU - Peter Sasieni Y1 - 2014/04/30 UR - http://ebm.bmj.com/content/early/2014/05/01/eb-2014-101757.abstract N2 - Commentary on: Elfström KM, Smelov V, Johansson AL, et al. Long term duration of protective effect for HPV negative women: follow-up of primary HPV screening randomised controlled trial. BMJ 2014;348:g130.OpenUrlAbstract/FREE Full Text 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. 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 … ER -