Phil B.FontanarosaMD, Deputy EditorIndividualAuthorStephen J.LurieMD, PhD, Contributing EditorIndividualAuthor
In Reply: We agree that HPV DNA testing should
not be used alone for general screening of young women because of the high
prevalence of infection in this age group. However, the complementary strengths
of HPV testing and Pap screening can improve cervical cancer prevention.
Oncogenic types of HPV cause nearly all cases of cervical carcinoma.1 In fact, viral DNA persistence is necessary for
the development of high-grade precursors and carcinomas.2,3
Consequently, HPV DNA testing is the most sensitive screening tool for the
detection of serious cervical neoplasia.4
This high sensitivity is critical, because, as a corollary, the predictive
value of a negative HPV test result is extremely high. The superior negative
predictive value of HPV DNA testing may safely permit longer screening intervals,
in addition to aiding in the triage of women with equivocal Pap test results.
Schiffman M, Hildesheim A, Herrero R, Bratti C. Human Papillomavirus Testing as a Screening Tool for Cervical Cancer—Reply. JAMA. 2000;283(19):2525-2526. doi:10.1001/jama.283.19.2521