“Our review of the data indicates that primary HPV testing misses less precancer and cancer than cytology alone,” the Interim Guidance Report’s lead author, Warner K. Huh, MD, division director and professor in the Division of Gynecologic Oncology at the University of Alabama in Birmingham said in a press release.3

The SGO/ASCCP’s guidelines also called for more studies, including direct cost comparisons.

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Just months later, a study based on approximately 8.6 million women age 30 to 65 years who received co-testing was published.4 Of those, 256 648 also received a biopsy to detect cancer, and 526 had confirmed cases of cervical cancer.

That analysis found that nearly 1 of every 5 women (18.6%) with confirmed cervical cancer had received a negative HPV test result—nearly 50% higher than the 12.2% that had a negative Papanicolaou  test, and triple the 5.5% that had a negative co-test result.

And, now, Dr Felix’s analysis plunges directly into the cost comparisons called for by the guidance report.

“There’s going to be a lot of people out there who are going to be surprised enough to be skeptical,” he said. “And that’s why you do a study: to provoke thought and to have other people either confirm or present data that contradicts you. And if they make a fair model, their data will not contradict us.”

RELATED: Adding Cediranib to Carboplatin, Paclitaxel May Improve Therapy Efficacy in Cervical Cancer

Despite the controversy over the best means for testing, the need for screening remains undisputed.

“The most important message for providers and the community is that women should be screened for cervical cancer,” ASCCP’s Chief Medical Officer Herschel Lawson, MD, said when the guidance was issued. “Screening saves lives.”3


  1. Felix J, Lacey MJ, Miller JD, et al. Clinical-economic modeling analysis of human papillomavirus (HPV) co-testing with genotyping versus primary HPV testing for cervical cancer screening. Poster presented at: ISPOR 18th Annual European Congress, November 7-11, 2015; Milan, Italy.
  2. Huh WK, Ault KA, Chelmow D, et al. Use of primary high-risk human papillomavirus testing for cervical cancer screening: interim clinical guidance. Gynecol Oncol. 2015;136(2):178-182.
  3. Medical Societies Recommend Consideration of Primary HPV Testing for Cervical Cancer Screening [news release]. Chicago, IL: American Society for Colposcopy and Cervical Pathology; January 8, 2016. http://www.asccp.org/about-asccp/news-announcements. Accessed February 12, 2016.
  4. Blatt AJ, Kennedy R, Luff RD, et al. Comparison of cervical cancer screening results among 256,648 women in multiple clinical practices. Cancer Cytopathol. 2015;123(5):282-288.