Cytology-based screening for cervical cancer has been criticised because of its high percentage of false-negative results. Considering HPV testing as an integral part of the screening process has been discussed as a way to address this issue in Germany. The aim of our study was to review trials comparing HPV testing with cytology in cervical cancer screening. Based on a systematic literature review, 14 studies with 85,820 women could be included. Generally HPV testing was more sensitive, but less specific than cytology. Based on the pooled data, sensitivity and specificity for HPV testing were 91% and 90%, respectively, whereas sensitivity and specificity for cytology amounted to 66% and 96%, respectively. Based on these results, including HPV testing in primary cervical cancer screening might lead to a reduction of false-negative results. Due the lower specificity false-positive test results would increase though.
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