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To the Editor In her Viewpoint about human papillomavirus (HPV) testing for primary cervical cancer screening, Feldman1 discusses the possible increase in costs, in particular for colposcopies. However, in the European trials, HPV-based screening followed by cytology triage of HPV-positive women was compared with screening based on Papanicolaou testing.2 The biopsy rate was so similar and with such narrow confidence intervals (relative risk, 1.02; 95% CI, 0.97-1.07) that there was strong evidence of a lack of difference between the approaches.2
Giorgi-Rossi P, Arbyn M, Meijer CJLM. Cervical Cancer Screening by Human Papillomavirus Testing Followed by Cytology Triage. JAMA Intern Med. 2015;175(6):1068. doi:10.1001/jamainternmed.2015.0592