Premature conclusions on HPV-only testing – Authors' reply

Abstract

We thank Jianyu Rao and colleagues for their comments, which permit us to clarify certain points. First, although more women tested positive for human papillomavirus (HPV) than had an abnormal Pap, 73% of the HPV-positive women had a concurrent normal Pap test and therefore did not undergo immediate colposcopy, as per guideline recommendations.1 In fact, 1063 more women were referred for colposcopy at enrolment on the basis of an abnormal Pap than a positive HPV test (4899 vs 3836, respectively; p<0·0001), which shows that guidelines help ensure that HPV testing does not lead to overtreatment.