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Adding Human Papillomavirus Testing to Cytology for Primary Cervical Cancer Screening: Shooting First and Asking Questions Later

George F. Sawaya, MD
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From San Francisco General Hospital, University of California, San Francisco, CA 94143-0856.


Potential Financial Conflicts of Interest:Grants received: Agency for Healthcare Research and Quality (related to use of HPV DNA testing and cytology). Other: Dr. Sawaya is a co-investigator on a National Institutes of Health–funded study on Hybrid Capture 2 testing and cytology after treatment of cervical intraepithelial neoplasia.

Requests for Single Reprints: George F. Sawaya, MD, Colposcopy Clinic, San Francisco General Hospital, University of California, San Francisco, 3333 California Street, Suite 335, San Francisco, CA 94143-0856.


Ann Intern Med. 2008;148(7):557-559. doi:10.7326/0003-4819-148-7-200804010-00013
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Annual cervical cancer screening is a well-established and highly effective routine practice in the United States (1), but it is also inefficient and expensive (2). A more streamlined approach would be to stratify women by risk and adjust the frequency of screening accordingly: Screen low-risk women infrequently, thereby minimizing the harms of screening, while focusing attention and resources on those at higher risk. Because oncogenic types of human papillomavirus (HPV) cause cervical neoplasia, HPV testing is a prime candidate to risk-stratify women for screening.

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High-resolution anoscopy in women with cervical neoplasia. Int J Gynaecol Obstet Published online Nov 8, 2014.;
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