{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,13]],"date-time":"2025-12-13T07:08:20Z","timestamp":1765609700318},"reference-count":34,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2016,3,23]],"date-time":"2016-03-23T00:00:00Z","timestamp":1458691200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cytopathology"],"published-print":{"date-parts":[[2017,2]]},"abstract":"<jats:p>As explained by Kitchener in a previous issue of <jats:italic>Cytopathology<\/jats:italic> (2015;<jats:bold>26<\/jats:bold>:4\u20106), primary human papillomavirus (<jats:styled-content style=\"fixed-case\">HPV<\/jats:styled-content>) testing is likely to be introduced in the <jats:styled-content style=\"fixed-case\">UK<\/jats:styled-content> for all women aged 25\u201364 years following pilot site studies already in place. This will be necessary when the prevalence of cervical cancer and its precursors declines when vaccination takes effect but there is a risk in abandoning cytology as a primary test: a risk that would be most apparent in the present unvaccinated population in which the prevalence of cervical cancer and its precursors is exceptionally high. <jats:styled-content style=\"fixed-case\">HPV<\/jats:styled-content> testing is more sensitive than cytology but has a significant false\u2010negative rate that could be detrimental to a successful screening programme if introduced without cytology backup. Accurate cytology would be needed for triage and could be compromised if <jats:styled-content style=\"fixed-case\">HPV<\/jats:styled-content>\u2010negative tests were excluded from examination.<\/jats:p><jats:p>This article proposes a compromise: cytology and <jats:styled-content style=\"fixed-case\">HPV<\/jats:styled-content> co\u2010testing for the first two screening tests to optimise the sensitivity of the test as a whole. Registrations of invasive and <jats:italic>in situ<\/jats:italic> carcinoma of the uterine cervix in England indicate that the prevalence of the disease is highest in young women in the early rounds of screening. Calculations of the likely impact on the workload of this proposal have been based on a service evaluation of 295 cytology tests received at St Thomas\u2019 Hospital, which suggests that the volume of cytology tests would be reduced by approximately 60% compared with 80% for primary <jats:styled-content style=\"fixed-case\">HPV<\/jats:styled-content> testing alone. This proposal should be debated openly before irrevocable changes are made to a skilled workforce.<\/jats:p>","DOI":"10.1111\/cyt.12334","type":"journal-article","created":{"date-parts":[[2016,3,23]],"date-time":"2016-03-23T05:55:42Z","timestamp":1458712542000},"page":"9-15","source":"Crossref","is-referenced-by-count":13,"title":["Primary HPV testing: a proposal for co\u2010testing in initial rounds of screening to optimise sensitivity of cervical cancer screening"],"prefix":"10.1111","volume":"28","author":[{"given":"A.","family":"Herbert","sequence":"first","affiliation":[{"name":"Cellular Pathology St Thomas\u2019 Hospital Guy's &amp; St Thomas\u2019 NHS Foundation Trust London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,3,23]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/cyt.12236"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)62218-7"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2012.06.095"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2011.01.008"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/0969141313492313"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10552-015-0568-6"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/bjc.2014.479"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.5858\/arpa.2010-0739-OA"},{"key":"e_1_2_8_10_1","unstructured":"MossS GibneyA.HPV primary screening pilots: evaluation report to the national screening committee. 20 February 2015. 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