Re: Age-Specific Evaluation of Primary Human Papillomavirus Screening vs Conventional Cytology in a Randomized Setting

Abstract

Leinonen et al. (1) recently reported results for women aged 25–65 years from the base line round of cervical screening in a Finnish randomized controlled trial that compared human papillomavirus (HPV) DNA screening with conventional cytology screening. The authors reported that HPV DNA screening combined with cytology triage had a specificity of 98.9% for cer vical intraepithelial neoplasia grade 3 or higher (CIN 3+; number of women with a negative screening test divided by total number of women screened minus the number with histologically confirmed CIN 3+). The same specificity was found for conventional cytology screening. In calcu lating these specificities, all women without a direct referral for colposcopy, that is, those with a less severe abnormality than low-grade squamous intraepithelial lesion on cytology, were considered screen nega tive. In this case, it is hardly surprising that the two screening methods appeared to have the same specificity, given that only a small proportion of low-grade squamous intraepithelial lesions or more severe ab