Market survey predictions on the future of US Pap testing

Abstract

With the identification of human papilloma virus (HPV) as the dominant etiologic agent of cervical cancer, [1,2] the introduction of FDA-approved adjunctive HPV DNA testing with cytology as early forms of etiology-based screening [3,4] and the recent introduction of FDA-approved vaccination for the two leading high-carcinogenic-risk HPV types, [5] it is perhaps not surprising that recent predictions about the future structure of cervical cancer prevention efforts in the USA and the size and scope of the role of the Papanicolaou test in US cervical cancer screening have varied greatly. Given the potential of primary HPV testing with cytology triage (cytology only after a positive HPV test) to substantially decrease Pap testing, [26,27] this finding is inconsistent with other survey data, and therefore we believe that respondents did not accurately understand this question. Since HPV DNA testing is already used for "primary screening" in the form of FDA-approved Pap and HPV co-testing, we believe that it is likely that many respondents simply misunderstood "cytology triage" as Pap and HPV co-testing.