A prospective study comparing cytology and high-risk HPV (hrHPV) testing performance in HPV-vaccinated young women within Scotland’s cervical screening programme.
hrHPV testing showed a high negative predictive value (98.9%) but a low positive predictive value (14.3%) for detecting cervical intraepithelial neoplasia grade 2 or worse (CIN2+), reflecting low disease prevalence in vaccinated populations.
High-grade cytology demonstrated a much higher PPV (71.7%) but lower NPV (89.2%), supporting cytology’s role as a triage method in hrHPV-positive women.
Study highlights the need for careful evaluation of screening algorithms in highly vaccinated cohorts due to changing prevalence and test performance.
