Researchers at Randers District Hospital have uncovered that offering human papillomavirus (HPV) screening to women aged 65 to 69 who have never had an HPV test can strengthen cervical cancer prevention by catching precancerous changes early. The findings were published in PLOS Medicine (PLOS Medicine).
HPV infection is linked to a higher risk of cervical cancer and several other malignancies. In many countries, testing for cancer-causing HPV strains remains the primary method for cervical cancer screening, yet a notable segment of women over 65 has never been screened for HPV. Debate continues about whether initiating HPV testing at an older age provides meaningful protection or leads to unnecessary procedures (PLOS Medicine).
The Danish study focused on all women aged 65 to 69 who had not undergone cervical cancer screening in the previous 5.5 years and had no recorded HPV test between ages 60 and 64. Invitations were extended to 11,192 women in one region, with screening offered through primary care or at home via a specialized test kit. A separate group comprising 33,387 women from four other regions served as the control, receiving cervical cytology instead of HPV-based screening. This design enables the detection of severe dysplasia, a precancerous condition of the cervix, through traditional cytology (PLOS Medicine).
Within the intervention group, 6,965 women (62.2%) underwent screening within 12 months. In the control group, 743 women (2.2%) had cervical cytology performed. The incidence of severe dysplasia (CIN2+) was 3.9 cases per 1,000 women in the HPV-screened cohort compared with 0.3 per 1,000 in the control group, suggesting that HPV-based screening can more effectively identify precancerous changes and enable timely treatment to reduce the risk of progressing to cancer (PLOS Medicine).
The study also highlighted that under-screened women aged 50 to 64 showed a higher prevalence of HPV and a greater likelihood of severe dysplasia than their peers who had been screened regularly, underscoring potential benefits of expanding HPV screening reach within this age range (PLOS Medicine).
These findings contribute to an ongoing conversation about age-specific screening strategies and the role of HPV testing in preventing cervical cancer across different populations. They align with broader public health goals to improve early detection, reduce cancer incidence, and tailor screening programs to individuals who have historically lacked regular testing (PLOS Medicine).