01-018 · EVIDENCE A · SOURCE-SENSITIVE
For women over 30, HPV testing should be the first choice for cervical cancer screening
30 岁以上女性做宫颈癌筛查，优先 HPV 检测
An HPV test costs between 100 and 300 yuan. Women with a negative result can get tested again only once every five years. The sampling process takes just a few minutes.
In that rural Indian trial, women who underwent just one HPV test in their lifetime had roughly half the risk of dying from cervical cancer and about 50% lower odds of being diagnosed with advanced-stage disease. At a cost of just 100–200 yuan per test, a negative result provides protection for five years.
A
Move “For women over 30, HPV testing should be the first choice for cervical cancer screening” to Future Me's calendar
The excuse
I can spend longer deciding whether to start than the small action would take.
What feels good now
Today I keep a little money, a few minutes and avoid interrupting my default routine.
What the source says
The source summarizes the return this way: “In that rural Indian trial, women who underwent just one HPV test in their lifetime had roughly half the risk of dying from cervical cancer and about 50% lower odds of being diagnosed with advanced-stage disease. At a cost of just 100–200 yuan per test, a negative result provides protection for five years.” Evidence grade A. The original states the population, caveats, and sources; this is not a personal forecast.
Use the original facts and limits. For an urgent medical, safety, financial, or legal issue, contact a qualified local professional or service.
THE ENGLISH EDITION
Original recommendation and evidence
18. For women over 30, HPV testing should be the first choice for cervical cancer screening
Cost: An HPV test costs between 100 and 300 yuan. Women with a negative result can get tested again only once every five years. The sampling process takes just a few minutes.
In plain terms: In that rural Indian trial, women who underwent just one HPV test in their lifetime had roughly half the risk of dying from cervical cancer and about 50% lower odds of being diagnosed with advanced-stage disease. At a cost of just 100–200 yuan per test, a negative result provides protection for five years.
Benefit: This trial in rural India used group-level rather than individual randomization, involving women aged 30–59. A single HPV test cut the risk of death from cervical cancer by roughly 48% (hazard ratio 0.52; 95% CI 0.33–0.83). It also reduced the likelihood of detecting late-stage disease by about 53% (HR 0.47; 95% CI 0.32–0.69).
Evidence grade: A
Sources: Sankaranarayanan R et al. (2009). HPV screening for cervical cancer in rural India. New England Journal of Medicine. <https://doi.org/10.1056/NEJMoa0808516>
Notes: Even women who have received the HPV vaccine still need screening, since the vaccine does not protect against all viral types. What makes this study unique is that it was a randomized screening trial with mortality as the primary outcome and only one round of testing performed.
Read the complete Chinese source and notes
18. 30 岁以上女性做宫颈癌筛查，优先 HPV 检测
成本: HPV 检测一次 100 到 300 元。结果阴性的，5 年查一次就行。取样几分钟。
说人话: 印度农村那项试验里，一辈子只做过一次 HPV 检测的女性，死于宫颈癌的概率低约一半，查出晚期宫颈癌的概率低约五成。一次一两百块，结果阴性能管 5 年。
收益: 印度农村那项试验按群体随机分组，不是按个人分组。对象是 30 到 59 岁的女性。只做一次 HPV 检测筛查，死于宫颈癌的风险就低约 48%。原值 HR 0.52，可信范围 95% CI 0.33 到 0.83。查出晚期宫颈癌的风险低约 53%（HR 0.47，95% CI 0.32 到 0.69）
证据等级: A
来源: Sankaranarayanan R 等 (2009). HPV screening for cervical cancer in rural India. New England Journal of Medicine. <https://doi.org/10.1056/NEJMoa0808516>
备注: 打过 HPV 疫苗的人也要筛查，因为疫苗盖不住全部的病毒型别。这项研究少见的地方是：它是随机分组的筛查试验，直接拿死亡人数当结果，而且只筛了一轮。
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