To the Editor In a recent issue of JAMA Oncology, Zhang et al1 reported a large-scale, open-label multicenter, randomized clinical trial comparing high-risk human papillomavirus (hrHPV) testing and cytology/visual inspection and found hrHPV to be an effective primary screening tool. We commend the authors on this study of timely relevance.
The findings by Zhang and colleagues1 come at a critical time when current global guidelines on cervical cancer screening methods are still in equipoise. Indeed, current evidence is lacking to further support broad recommendations from the World Health Organization for human papillomavirus (HPV) testing as a screening method in women older than 35 years in countries with the resources to do so.2 Not only does this study have implications for China’s national screening program, but it also provides evidence to support hrHPV screening protocols to facilitate the World Health Organization’s goal of eliminating cervical cancer through the use of a precise test to screen 70% of women by age 35 and 45 years by 2030, combined with 90% vaccine coverage and 90% access to treatment for precancerous lesions and cancer.3 With this in mind, we would like to ask Zhang et al1 the following questions to better understand the implications of their findings.