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Volume-12 Number-3, 2025 / Review Article

Incorporation of HPV DNA Testing alongside Pap smears Increases Sensitivity for Cervical Cancer Screening

Author:

Nupur Garg

Department of Community Medicine, Guru Gobind Singh Medical College, Faridkot, Punjab, India-151203

Shekhar Srivastava

Department of Community Medicine, Era’s Lucknow Medical College and Hospital, Era University, Lucknow, Uttar Pradesh, India-226003

Abstract:

Introduction: Cervical cancer is a malignant tumor that is caused by unremitting high-risk human papillomavirus (HPV) infection and is one of the most prevalent causes of cancer-related death in the world. Over the decades, major screening modality was cytology (Pap smear), but this screening modality is limited by low sensitivity. The review is a synthesis of peer-reviewed articles in recent few years to test the hypothesis that HPV DNA testing when used with cytology (co-testing), has a higher screening sensitivity and puts the proposed methodology into perspective of the newly developing paradigm of primary HPV testing. Consecutive evidence shows that a primary HPV test holds distinctly high CIN 2+ sensitivity (95.93) in comparison with the screening method (cytology 98.03), although with substantial better specificity (86.83) (moderately versus 79.83). Large-scale trials, however, have been able to establish significantly higher specificity (86.83), with a primary HPV test (95.93), which is comparable to secondary HPV testing.

Methodology: The literature search of the scientific literature published in the few past year was conducted systematically. The information was synthesised through randomised controlled trials, meta-analyses, epidemiological and clinical guidelines published by the leading organisations (WHO, ACS, ASCCP and FOGSI).

Conclusion: Cervical cancer screening has improved significantly in terms of sensitivity and long-term efficacy with the incorporation of HPV DNA testing. Although co-testing has been an important transitional model, it is now widely accepted that the new gold standard, primary HPV testing has provided an internalized position of clinical advantage (sensitivity) and possible harm (specificity, colposcopy rates). The eradication of cervical cancer globally has now become pegged on the implementation of these objective, high-performance molecular diagnostics through scalable, cost-effective and patient strategies.

Keywords:

Cervical cancer, Human papillomavirus, Pap smear.

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View in DOI 10.24041/ejmr.2025.50