CTF Summary Table: Screening for Human Papillomavirus Infection

Canadian Task Force on Preventive Health Care

Summary Table of Recommendations

Screening for Human Papillomavirus Infection

Prepared by J. Kenneth Johnson, MD, Research Associate, Department of Preventive Medicine and Biostatistics, University of Toronto, Ontario

These recommendations were finalized by the Task Force in June 1992

MANEUVER EFFECTIVENESS LEVEL OF EVIDENCE <REF> RECOMMENDATION

Human Papillomavirus (HPV) screening (added to Pap smear screening for cervical cancer*) using any of the following diagnostic tests: Visual inspection, Pap smear, Colposcopy/cervicography HPV group-specific antigen, DNA probe, Dot blot, Southern Blot or polymerase chain reaction. HPV is associated with risk and grade of cervical cancer. Cohort <3-6>and Case-control <8,11> studies (II-2) Fair evidence to exclude from periodic health examination. (D)

The natural history of untreated HPV infection is poorly understood and there is no effective therapy that produces long-term success. Randomized controlled trials <26-29,33> (I); cohort studies <27> (II-2) and case series <24> (III) for various therapies.

HPV diagnostic maneuvers have poor test characteristics or are invasive, costly or inadequately studied. Adverse effects of screening include: morbidity of testing and treatment, associated costs and labelling. Adding HPV screening to screening protocols for cervical cancer has not been studied. Case Series <3,11,15,19-24> (III)

* The Task Force recommends Pap smear screening (B Recommendation), see Chapter 73.

Link to Full Text of this review

Link to Structured Abstract of this review

Link to Selected References list of this review

Link to 1995 update: Screening for human papillomavirus infection in asymptomatic women

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MANEUVER	EFFECTIVENESS	LEVEL OF EVIDENCE <REF>	RECOMMENDATION
Human Papillomavirus (HPV) screening (added to Pap smear screening for cervical cancer*) using any of the following diagnostic tests: Visual inspection, Pap smear, Colposcopy/cervicography HPV group-specific antigen, DNA probe, Dot blot, Southern Blot or polymerase chain reaction.	HPV is associated with risk and grade of cervical cancer.	Cohort <3-6>and Case-control <8,11> studies (II-2)	Fair evidence to exclude from periodic health examination. (D)
	The natural history of untreated HPV infection is poorly understood and there is no effective therapy that produces long-term success.	Randomized controlled trials <26-29,33> (I); cohort studies <27> (II-2) and case series <24> (III) for various therapies.
	HPV diagnostic maneuvers have poor test characteristics or are invasive, costly or inadequately studied. Adverse effects of screening include: morbidity of testing and treatment, associated costs and labelling. Adding HPV screening to screening protocols for cervical cancer has not been studied.	Case Series <3,11,15,19-24> (III)