Guglielmo Ronco

TL;DR: Data of large-scale randomised trials support initiation of HPV-based screening from age 30 years and extension of screening intervals to at least 5 years, and provide 60-70% greater protection against invasive cervical carcinomas compared with cytology.

TL;DR: Heterogeneity in HPV type distribution among women from different populations should be taken into account when developing screening tests for the virus and predicting the effect of vaccines on the incidence of infection.

TL;DR: HPV-based screening is more effective than cytology in preventing invasive cervical cancer, by detecting persistent high-grade lesions earlier and providing a longer low-risk period, but in younger women, HPV screening leads to over-diagnosis of regressive CIN2.

TL;DR: There exists a substantial evidence base to support that HPV testing is advantageous both in triage of women with equivocal abnormal cytology, in surveillance after treatment of CIN lesions and in primary screening of women aged 30 years or older, however, the possible advantages offered by HPV-based screening require a well organised program with good compliance with screening and triage policies.

TL;DR: The greater sensitivity of HPV DNA testing compared to cytology argues strongly for using HPVDNA testing as the primary screening test in newly implemented programmes, except where resources are extremely limited and only programmes based on visual inspection are affordable.