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BMJ. 2007 October 13; 335(7623): 745.
PMCID: PMC2018788
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DNA test outperforms cytology in Dutch cervical screening

Testing for DNA from human papillomaviruses is a more sensitive cervical screening tool than traditional cytology. DNA testing picks up more high grade lesions. It also picks them up earlier, according to a randomised trial.

Women in the Dutch screening programme were screened with cytology or with a combination of cytology and DNA testing. Five years later, all the women had both tests done.

As expected, combined testing picked up significantly more high grade lesions than cytology in the first round of screening (68/8575 v 40/8580; 70% increase, 95% CI 15% to 151%, P=0.007). In the next round, the women in the combined group still had fewer high grade lesions than controls (24/8413 v 54/8456; 55% decrease, 28% to 72%, P=0.001). DNA testing had allowed earlier detection of persisting lesions, not just those likely to regress spontaneously. The total number of lesions detected was similar in both groups.

Should national screening programmes now add DNA tests to routine cervical cytology? Not yet, say the authors. These results should be verified first, then someone needs to look carefully at costs. But if all goes well, a testing protocol that picks up serious lesions earlier could mean a longer screening interval for women.

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