Recommendations for the general population of women . In settings with high follow-up capacity (60% or greater) and sufficient ablative treatment capacity, WHO suggests using HPV DNA testing with extended or limited genotyping OVER treating all HPV-positive women or triaging all HPV-positive women with additional tests. In settings with high follow-up capacity (60% or greater) and sufficient ablative treatment capacity where HPV DNA extended genotyping is used, WHO suggests: • treating all eligible women with ablative treatment who test positive for carcinogenic HPV (cHPV) types 16 (group 1a), 18 and 45 (group 1b) and 31, 33, 35, 52 and 58 (group 1c); AND triaging women who test positive for cHPV types 39, 51, 56 and 59 (group 1d); OVER • treating all eligible women with ablative treatment who test positive for cHPV types 16 (group 1a), 18 and 45 (group 1b), AND triaging women who test positive for cHPV types 31, 33, 35, 52, 58, 39, 51, 56 and 59 (groups 1c and 1d); OVER • treating all eligible women with ablative treatment who test positive for cHPV types 16 (group 1a), 18 and 45 (group 1b) AND triaging women who test positive for cHPV types 31, 33, 35, 52 and 58 (group 1c) AND returning women who test positive for cHPV types 39, 51, 56 and 59 (group 1d) to routine screening.StatusNewRecommended in favorConditionalCertainty of evidenceLow
Recommendations for the general population of women . In settings with low follow-up capacity (less than 60%) and sufficient ablative treatment capacity, WHO suggests: • treating all eligible women with ablative treatment who test positive for any carcinogenic HPV (cHPV) types 16 (group 1a), 18 and 45 (group 1b), 31, 33, 35, 52 and 58 (group 1c), 39, 51, 56 and 59 (group 1d), consistent with a no-genotyping approach; • OR treating eligible women with ablative treatment who test positive for any cHPV types 16 (group 1a), 18 and 45 (group 1b) and 31, 33, 35, 52 and 58 (group 1c) [This can be done using an 8-cHPV type test (tests designed to detect the eight most cHPV types) as per WHO target product profiles for HPV screening tests, or when using extended genotyping HPV tests.] OVER • treating all eligible women with ablative treatment who test positive for cHPV types 16 (group 1a), 18 and 45 (group 1b) AND triaging women who test positive for cHPV types 31, 33, 35, 52, 58, 39, 51, 56 and 59 (groups 1c and 1d); or OVER • triaging with additional tests all women who test positive for any cHPV types (1a, 1b, 1c and 1d).StatusNewRecommended in favorConditionalCertainty of evidenceLow
(Screening and treatment of cervical pre-cancer lesions for cervical cancer prevention: use of human papillomavirus (HPV) DNA genotyping) Recommendations for the general population of women. Regardless of follow-up capacity If a programme provides triage with additional tests, WHO suggests using visual inspection with acetic acid (VIA) or colposcopic impression (without histological confirmation) as the triage test rather than cytology or dual-stain cytology.StatusNewRecommended in favorConditionalCertainty of evidenceLow