| Table 5: Summary of manoeuvre, effectiveness, levels of evidence and recommendation for the screening of HPV infection in asymptomatic women | |||
| Manoeuvre | Effectiveness | Level of evidence* | Recommendation* |
| HPV screening (beyond Papanicolaou testing for cervical cancer) using any of the diagnostic tests mentioned in Table 3 | HPV infection is associated with risk and grade of cervical cancer
The natural history of untreated HPV infection is poorly understood, and there is no effective therapy for long-term success Diagnostic manoeuvres have poor test characteristics regarding HPV or are invasive, costly or inadequately studied. Adverse effects of screening include morbidity of testing and treatment, associated costs and labelling. Adding HPV screening to screening protocols for cervical cancer has not been studied | Cohort [9,41-43] and case-control [10,11] studies (II-2)
Randomized controlled trials [59,65-67,69] (I), cohort study[68] (II-2) and case series [62-64] (III) for various therapies Case series 9,11,20,53-58 |
Fair evidence to exclude from the periodic health examination (D) |
*For descriptions of levels of evidence and classification of recommendations see Appendix 1 in part 1 of the 1992 update (Can Med Assoc J 1992; 147: 443)