HPV testing to be assessed as primary screening tool for cervical cancer prevention

At the request of the National Screening Service, HIQA will undertake a health technology assessment (HTA) to independently evaluate the clinical, financial, ethical and organisational implications of establishing human papillomavirus (HPV) testing as the primary screening test for preventing cervical cancer.

At present, liquid-based cytology is used as the primary screening tool by the National Cervical Screening Programme (CervicalCheck).

If low grade abnormalities are detected, the same sample is tested for HPV DNA to determine if the woman should be referred for colposcopy or back to routine screening. Using HPV DNA testing as the primary test, followed by liquid-based cytology, has the potential to improve the detection of cancerous and pre-cancerous cell changes and to increase the efficiency of the screening process.

Dr Máirín Ryan, HIQA’s Director of Health Technology Assessment, commented: “By examining international evidence on the clinical and cost-effectiveness of HPV testing — and by modelling these benefits, along with the budget impact of switching to HPV DNA testing for the Irish healthcare system — we will be in a position to provide independent advice on the optimal screening strategy for preventing cervical cancer in Ireland.”

HPV is a common virus usually spread by skin-to-skin contact during sexual contact. In most cases, it causes no symptoms and is cleared by the body’s immune system. However, persistent infection with a number of HPV virus types can lead to the development of cervical cancer.

An expert advisory group comprising key stakeholders is being formed and will advise the HTA evaluation team during the course of this assessment, according to HIQA.

The final results of the HTA, which are expected at the end of the year, will be submitted to the National Screening Service for consideration.