Table 2. Evidence-based statements about the use of HPV test in primary screening.

1	High-risk HPV DNA testing alone, as a primary screening method, has been shown to be more sensitive than cytology in several clinical studies (AI).
2	HC2 proved to be superior to Pap smear screening in reducing cervical cancer mortality in one trial in rural India (AI).
3	The negative predictive value of HR HPV DNA testing every 6 years was higher than the negative predictive value of Pap smear screening every 3 years in a recent metanalysis; six of the seven studies analyzed used HC2 as the HPV testing method (AI).
4	It is appropriate to begin large scale demonstration projects using HPV screening as the sole primary screening test in patients older than 30 years (AIII).
5	Efficient management of women who are HPV positive based on a single screening test remains a key issue for primary screening. Cytologic triage of HPV positive women with retesting for HPV at one year (or possibly two years) for those who are HPV positive and cytology negative appears to be the most feasible option (AI). Other options include: HPV genotyping for types 16, 18 and possibly 45 (AII) or triage using P16 on the cytology slide prepared from the original HPV testing fluid (AI).
6	Co-testing (simultaneous cytology and HPV testing) offers the highest negative predictive value at a cost of more than double the tests needed; however, double testing does not significantly affect the positive predictive value of single testing (no significant increase in colposcopic examinations) (AI).
7	HPV testing is superior to cervical cytology in inter-laboratory and inter-observer variability (AI). However it is important that HPV testing be conducted with a clinically validated test to ensure that results are objective and highly reproducible.
8	HC2 is clinically validated in population screening (AI) and shows high inter and intra-laboratory reproducibility (AII).
9	HPV testing is the most sensitive and specific screening test in the post vaccination (AIII).