Re: A Study of the Impact of Adding HPV Types to Cervical Cancer Screening and Triage Tests

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Abstract
In a recent article in the Journal, Schiffman et al. ( 1 ) showed that testing for more than about 10 human papillomavirus (HPV) types decreased specificity for detection of cervical intraepithelial neoplasia grade 3 (CIN3) and cancer more than it increased sensitivity in the ASCUS/LSIL Triage Study (ALTS) and, most notably, in the Proyecto Epidemiológico Guanacaste (PEG). To further elucidate which HPV types are the strongest predictors of the risk of CIN3 and cancer, we compared our three large systematic reviews on the distribution of HPV types in low-grade squamous intraepithelial lesions [LSILs; 8308 women from 50 studies ( 2 ) ], high-grade squamous intraepithelial lesions [HSILs; 4338 women from 52 studies ( 3 ) ], and squamous cell cervical carcinoma [SCC, 10 058 women from 85 studies ( 4 ) ].