Primary HPV Testing vs. Co-testing for Cervical Cancer Screening

. Where the Story Begins The incidence of cervical cancer in the US has declined dramatically over the last half century and continues to decline to this day. In 1975, the incidence of cervical cancer was 14.8 per 100,000 women; by the year 2013 that number was only 6.4 per 100,000. Similarly, the mortality due to cervical cancer during the same period was reduced from 5.6 to 2.3 women per 100,000.** It is widely accepted that secondary prevention of cervical cancer, i.e., the detection and eradication of precancerous lesions, is almost entirely responsible for this observed reduction, and clearly the most important step at which to intervene.1 The Pap test, developed by George Papanicolau in 1941, gained widespread use in the 1960s and became a part of a well-woman exam. Although many have questioned the clinical sensitivity of the Pap test, its efficacy in reducing cervical cancer is unchallenged. In the US, the Pap test is thought to be responsible for an 80% reduction in the incidence of cervical cancer.2 Comparing rates of cervical cancer from countries that have implemented national screening programs, such as Great Britain, to countries where no such programs exist, such as Brazil, shows astonishing differences. While the incidence in both countries is similar in women under the