Professor Henry Kitchener led a trial investigating HPV as a primary screening test. The trial, entitled ARTISTIC (A Randomised Trial of HPV Testing in Primary Cervical Screening) took place in Manchester, Stockport, Wigan & Leigh and Salford & Trafford, and began in June 2001.
The aim of the trial was to
- Provide clear evidence on the costs, medical effects and psychosocial impact of adding HPV testing to cervical cytology
- Provide an estimate of the effectiveness and costs of HPV as a stand-alone test
- Determine the contribution of HPV detection to the cervical screening programme, particularly to sensitivity, specificity and inadequate tests
- Address methodological issues in HPV testing
The study population comprised 25,000 women aged 20-64 who attended general practices for routine cervical screening and who consented to having an HPV test.
The ARTISTIC trial is continuing to follow up women while maintaining the randomised concealment of HPV testing results for a further 3-year round of screening. This will allow evaluation of the risk of developing cytological abnormalities in type-specific HPV-positive and HPV-negative women over a 6-year interval. It will be important in developing screening protocols for the post-vaccination era, when the case for initial HPV testing with cytology triage will become stronger.
The ARTISTIC findings suggested that LBC, which has been implemented countrywide, would not benefit from combined testing with HPV.
For the full report see http://www.hta.ac.uk/execsumm/summ1351.shtml.