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Comment & Response
June 2015

Cervical Cancer Screening by Human Papillomavirus Testing Followed by Cytology Triage

Author Affiliations
  • 1Interinstitutional Epidemiology Unit, AUSL (Azienda Unità Sanitaria Locale) Reggio Emilia, Reggio Emilia, Italy
  • 2Arcispedale S. Maria Nuova, IRCCS (Istituto di Ricovero e Cura a Carattere Scientifico), Reggio Emilia, Italy
  • 3Unit of Cancer Epidemiology and Belgian Cancer Centre, Scientific Institute of Public Health, Brussels, Belgium
  • 4Department of Pathology, Vrije Universiteit Medical Center, Amsterdam, the Netherlands
JAMA Intern Med. 2015;175(6):1068. doi:10.1001/jamainternmed.2015.0592

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

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