ArticleThe Lancet regional health. Europe2026
Primary Human Papillomavirus Screening Versus Cytology for Detection of Cervical Intraepithelial Neoplasia Grade 2 or Higher in Poland: a Parallel-Group, Randomized Controlled Trial.
Article in The Lancet regional health. Europe, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Towards HPV-Based Cervical Cancer Screening in Poland: Lessons From a Landmark Trial.The Lancet regional health. Europe · 2026Article
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Authors and funding
14 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: 2025 European guidelines recommended transition from cytology to HPV-based cervical cancer screening. We compared both strategies in a pilot in Poland. Methods: Eligible, consenting women aged 30-59 years underwent centralized 1:1 randomization to HPV-testing or cytology (HPV or cytology arm, respectively) in 30-39, 40-49, and 50-59 years age strata in 27 clinics. Arm assignment was unblinded. HPV positive samples underwent liquid-based cytology (LBC) triage. If normal, another LBC was performed in six months. Abnormal LBC triggered colposcopy. If both LBCs were normal, p16/Ki-67 immunocytochemistry and Findings: Between 28 October 2019 and 31 December 2022, 16,795 and 16,707 women underwent primary HPV or cytological testing, respectively. 702/16,795 (4.2%; 95% CI: 3.9%-4.5%) and 499/16,707 women (3.0%; 95% CI: 2.7%-3.3%), were referred for colposcopy in the HPV and cytology arm, respectively (RR = 1.40; 95% CI: 1.25-1.57). CIN2+ was detected in 137 women (0.82%; 95% CI: 0.69-0.96%) and in 71 women (0.42%; 95% CI: 0.34-0.54%; OR = 1.93; 95% CI: 1.34-2.77), while CIN grade 3 or worse (CIN3+) was detected in 69 women (0.41%; 95% CI: 0.32%-0.52%) and in 35 women (0.21%; 95% CI: 0.15%-0.29%; OR = 1.99; 95% CI: 1.16-3.42) in the HPV and cytology arm, respectively. In HPV positive women with two normal LBCs immunocytochemistry and methylation detected 4/9 (44.4%) and 7/9 (77.8%) CIN2+ cases, respectively. Interpretation: HPV-based screening may almost double CIN2+ detection compared to cytology. It however yields more positive screening results and colposcopies. Smooth transition from cytology to HPV-based screening requires proper triage strategies and additional colposcopy services. Methylation seems to detect more CIN2+ than immunocytochemistry in HPV positive women with two normal LBCs. Funding: Polish Ministry of Health.
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