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Objectives for meta-analysis. The objectives for reviewing HPV screening trials were to(i) determine the age-specific HPV prevalence in differentEuropean areas,(ii) evaluate the sensitivity and specificity of HPV testingin women attending routine screening,(iii) compare the sensitivity and specificity of HPV testingwith that of routine cytology.StudiesStudies included were from the UK (HART [13], Hammersmith[16]); France (Reims [17]); Germany (Hannover andTuebingen [18], Jena [19]); and the Netherlands (Amsterdam[20]) (Figure 1).Comparisons were also made with North Americanscreening studies reported by Ratnam et al [21] and Kulasingamet al [22].Testing for HPVAcross the European studies, the HC II test for HPV had asensitivity of 96% and specificity of 92%, whereas cytologybased on Pap smears had a sensitivity of 63% and specificityof 96%.Although the performance of HPV testing is similar indifferent areas of Europe, the sensitivity of cytology is highlyvariable between countries.HPV as a sole primary screening testThere are a number of potential advantages in using HPVtesting (HC II) as the sole primary screening test for cervicalcancer. Due to its automated, highly sensitive, and objectivenature, results are less variable and quality controlis simpler. Cytology could thus be reserved for 6-10% ofwomen; screening would be undertaken in more detail bya smaller number of more focused cyto-screeners. Triage ofHPV-negative ASCUS/LSIL lesions would be eliminated.Screening intervals could be longer with potential costsavings and greater convenience. [ABSTRACT FROM AUTHOR]