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One round of HPV testing in rural Indian villages halved deaths from cervical cancer within eight years, while a Pap smear or a visual check did not, which is why HPV tests are now the world's preferred screen.
131,746 women aged 30 to 59 in 52 village clusters were randomised to HPV testing (34,126), cytology (32,058), visual inspection with acetic acid (34,074) or standard care (31,488). In the HPV arm there were 39 advanced cancers versus 82 in the control group (hazard ratio 0.47; 95% CI 0.32-0.69) and 34 cervical cancer deaths versus 64 (hazard ratio 0.52; 95% CI 0.33-0.83); neither cytology nor visual inspection significantly reduced advanced cancers or deaths, and adverse events occurred in 0.1% of screened women. The result made a single round of HPV testing the evidence base for WHO's HPV-first screening recommendation and for India's own screening guidance.
Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.
Shares HPV screening for cervical cancer in rural India (Osmanabad), Mumbai VIA cervical screening trial (Tata Memorial), Colposcopy and excisional treatment (LEEP/LLETZ, cone), HPV DNA testing and self-sampling.
Shares Colposcopy and excisional treatment (LEEP/LLETZ, cone), HPV DNA testing and self-sampling, Prevention we already have is not deployed, The hardest cancers are found late.
Shares Rengaswamy Sankaranarayanan, Tata Memorial Centre, International Agency for Research on Cancer (IARC / WHO), Cancer prevention roadmap: tobacco control and vaccines → biomarker-guided chemoprevention → interception in carriers.
Shares Rengaswamy Sankaranarayanan, Cluster-randomised trial, International Agency for Research on Cancer (IARC / WHO), Global access and affordability roadmap: essential medicines and generics → biosimilars and frugal trials → reliance, pooling and homegrown innovation.
Shares Visual inspection with acetic acid (VIA) for cervical screening, Global access and affordability roadmap: essential medicines and generics → biosimilars and frugal trials → reliance, pooling and homegrown innovation, Prevention we already have is not deployed, Most of the world has almost no cancer care.
Shares HPV DNA testing and self-sampling, International Agency for Research on Cancer (IARC / WHO), Cancer prevention roadmap: tobacco control and vaccines → biomarker-guided chemoprevention → interception in carriers, Prevention we already have is not deployed.
Shares International Agency for Research on Cancer (IARC / WHO), Cancer prevention roadmap: tobacco control and vaccines → biomarker-guided chemoprevention → interception in carriers, Prevention we already have is not deployed, Most of the world has almost no cancer care.
Shares International Agency for Research on Cancer (IARC / WHO), Cancer prevention roadmap: tobacco control and vaccines → biomarker-guided chemoprevention → interception in carriers, Prevention we already have is not deployed, Most of the world has almost no cancer care.