This week''s NEJM reports on a landmark randomized clinical trial from India, involving over 130,000 women. The trial clearly demonstrated that a single HPV test between the age of 30 and 59 dramatically reduced the incidence of, and mortality from, cervical cancer within 8 years. The reduction was far greater than a single conventional cytology test or visual inspection of the cervix with acetic acid (VIA). HPV testing was the most objective and reproducible of all cervical screening tests and was less demanding in terms of training and quality assurance.
The conclusion in an accompanying editorial was straightforward: International experts in cervical-cancer prevention should now adopt HPV testing for widespread implementation.