On average, it takes 15 years from the landmark publication on a cancer control evidence-based intervention to achieve 50% uptake in routine practice.¹ In fact, nearly 20 years have passed since the first observational studies showed that human papillomavirus (HPV) DNA testing had substantially higher sensitivity for detecting cervical precancer and cancer compared with cervical cytology.² Since then, the performance of HPV testing in primary cervical screening has been evaluated globally, and several large randomised controlled trials have shown that a negative HPV test provides long-term protection against invasive cervical cancer.3, 4 In line with this evidence, the WHO 2021 and the WHO 2024 guidelines recommend the use of HPV testing over cervical cytology or visual inspection of the cervix (VIA) in primary screening to prevent cervical cancer following simple algorithms for either screen-and-treat, or screen, triage (using cytology, dual-stain [p16/Ki67] cytology, VIA, or colposcopy), and treat. Despite the evidence and recommendations supporting HPV detection as primary screening test, it has not yet led to widespread transition from cytology-based to HPV-based cervical screening.

中文翻译：

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支持过渡到基于 HPV 的宫颈癌筛查的实施工作


平均而言，从发表关于癌症控制循证干预的里程碑式出版物开始，需要 15 年时间才能在常规实践中实现 50% 的采用率。¹ 事实上，自从首次观察性研究表明，与宫颈细胞学相比，人瘤病毒 （HPV） DNA 检测在检测宫颈癌前病变和癌症方面的敏感性要高得多，已经过去了近 20 年。² 从那时起，HPV 检测在初级宫颈筛查中的性能得到了全球评估，几项大型随机对照试验表明，HPV 检测阴性可提供针对浸润性宫颈癌的长期保护。3， 4 根据这一证据，WHO 2021 和 WHO 2024 指南建议在初步筛查中使用 HPV 检测而不是宫颈细胞学或宫颈肉眼检查 （VIA） 来预防宫颈癌，遵循简单的筛查和治疗或筛查分诊算法（使用细胞学、双染色 [p16/Ki67] 细胞学、VIA 或阴道镜检查）， 和治疗。尽管有证据和建议支持 HPV 检测作为初步筛查测试，但它尚未导致从基于细胞学的宫颈筛查到基于 HPV 的宫颈筛查的广泛过渡。