TY - JOUR T1 - HPV testing and vaccination in Europe. JF - J Low Genit Tract Dis Y1 - 2014 A1 - Leeson, Simon C A1 - Alibegashvili, Tamar A1 - M. Arbyn A1 - Bergeron, Christine A1 - Carriero, Carmine A1 - Mergui, Jean-Luc A1 - Nieminen, Pekka A1 - Prendiville, Walter A1 - Redman, Charles W E A1 - Rieck, Gudrun C A1 - Quaas, Jens A1 - K Ulrich Petry KW - Early Detection of Cancer KW - Europe KW - Female KW - Human Papillomavirus DNA Tests KW - Humans KW - Papillomaviridae KW - Papillomavirus Infections KW - Papillomavirus Vaccines KW - Uterine Cervical Neoplasms KW - Vaccination AB -

Current cytology-based screening has a moderate sensitivity to detect cervical intraepithelial neoplasia grade 3 (CIN 3) and cervical cancer even in those states providing rigorous quality control of their cervical screening programs. The impact of vaccination against human papillomavirus (HPV) types 16 and 18 as well as the incorporation of HPV testing on the detection of CIN 3 and cancer is discussed. HPV testing used as a triage for atypical squamous cells of undetermined significance (ASCUS) and low-grade squamous intraepithelial lesions, test of cure after treatment, and HPV-based primary screening may improve current cervical screening programs.HPV testing as a triage test for ASCUS seems to offer an improved sensitivity, with a similar specificity as compared to repeat cytology for diagnosing high-grade CIN and has been recommended throughout most EU states. HPV testing as a triage test for low-grade squamous intraepithelial lesions has a low specificity and is not recommended in most member states. HPV test of cure offers an improved sensitivity compared to cytology for women with persistent cervical precancer after treatment. HPV-based cervical cancer screening is more effective than screening with cytology. The effects of HPV-based screening depend on the organization of the program and on adherence to algorithms for screening triage. Otherwise, it is likely that HPV-based screening will increase the referral rate to colposcopy including more women with no detectable cervical lesion. HPV vaccination will require many years to evaluate any beneficial effects on cervical cancer incidence and mortality.

VL - 18 CP - 1 U1 - http://www.ncbi.nlm.nih.gov/pubmed/23774078?dopt=Abstract M3 - 10.1097/LGT.0b013e318286b8d3 ER -