HPV Testing Versus Cytology for Cervical Cancer Screening Among Women 50 Years and Older: Evidence From the HPV FOCAL Randomized Controlled Trial.
Int J CancerJun 27, 2026 (epub)
Md Saiful Alam, Laurie W Smith, Lovedeep Gondara et al.
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In 30 seconds
This randomized controlled trial evaluated the effectiveness of HPV testing versus cytology for cervical cancer screening in 6471 women aged 50 years and older. The study found that HPV testing resulted in a lower incidence of CIN2+ lesions compared to cytology, with a detection rate of 1.61/1000 versus 3.15/1000, and a risk ratio of 0.51. This suggests HPV testing is superior for this population.
Key findings
- CIN2+ detection was 1.61/1000 for HPV-negative women versus 3.15/1000 for cytology.
- The risk ratio for CIN2+ detection comparing HPV to cytology was 0.51.
- 50% of CIN2+ cases were missed with cytology re-screening compared to 30% with HPV testing.
- The hazard ratio for CIN2+ comparing HPV to cytology was 0.44.
Why it matters
The findings highlight the importance of using HPV testing over cytology for cervical cancer screening in women aged 50 and older, as it leads to better detection rates and fewer missed lesions, potentially improving patient outcomes.