Women over 30 should get cervical cancer screening, with an HPV test first

High value
Evidence A
Buys life
For: Women
Costs a little
Takes minutes
No willpower

In plain words

In the rural India trial, women who had just one HPV test in their lives were about half as likely to die of cervical cancer, and about half as likely to be found with advanced cervical cancer. One or two hundred CNY a test, and a negative result lasts 5 years.

Cost: An HPV test costs 100 to 300 CNY. If the result is negative, testing every 5 years is enough. Taking the sample takes a few minutes.
What you get: The rural India trial was randomized by community, not by individual. It enrolled women aged 30 to 59. A single round of HPV testing lowered the risk of dying from cervical cancer by about 48% (HR 0.52; 95% CI 0.33 to 0.83, the plausible range). The risk of being found with advanced cervical cancer was about 53% lower (HR 0.47, 95% CI 0.32 to 0.69).
Notes: People who have had the HPV vaccine still need screening, because the vaccine doesn't cover every virus type. What is unusual about this study is that it is a randomized screening trial that used the number of deaths directly as its result, and it screened only one round.
Evidence grade: A : Specific numbers from meta-analyses, large cohorts or randomized trials; for law and policy, the statute or official text.
Sources: Sankaranarayanan R 等 (2009). HPV screening for cervical cancer in rural India. New England Journal of Medicine. https://doi.org/10.1056/NEJMoa0808516

Mentioned in

Translated from the Chinese original. Original book, section 1, tip 18. This section is about health and medicines. It is general information, not a substitute for a doctor’s diagnosis or prescription. Content may be out of date and rules differ by place. When you actually deal with an agency, a doctor or a court, follow what local officials, doctors and lawyers tell you. Disclaimer