Cervical screening: toward an equal risk/equal management approach, irrespective of HIV status

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Excerpt

The introduction of human papillomavirus (HPV) testing has the potential to improve the accuracy of cervical cancer screening, but it has led to a multiplicity of possible protocols. So the decision to establish guidelines based on risk thresholds (benchmarks) to allow equal management for equal risk, irrespective of the screening test, is highly appropriate [1]. In the United States, for example, the benchmark that allows for a ‘routine’ recall after 3 years is a risk of biopsy-confirmed cervical high-grade squamous intraepithelial neoplasia or worse (bHSIL+) of 0.69%, based on the 3-year risk associated with a negative cytology. The benchmarks for 6–12-month return and for immediate colposcopy are 3-year risk of 8.8 and 14.4%, respectively [2].

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