It strongly depends on the available infrastructures and skills, however I think that the FDA-approved Digene hybrid capture system could be the best approach for a rapid and simple population-based HPV screening, given that it does not require DNA extraction and amplification, and can distinguish between low and high risk HPV genotypes.

Hope it may help

I aggree with previous participant. In our hospital we use PCR COBAS 4800 in order to distinguish HPV 16 m HPV 18 anr others high-rosk serotypes and recommend or not recommend HPV vaccination

If you are in need of robust and an easy to handle test you could use the careHPV test. It is similiar to the HPV test from Qiagen (formely Digene) but not the same Yet, if you are interested in more specific information (Genotypes) you should think about some alternatives that will allow you to identify persistent infections.

There is a vast literature about the characteristics that a HPV-DNA test should have to be used in screening. The reference text is the paper Meijer CJ, Berkhof J, Castle PE, Hesselink AT, Franco EL, Ronco G, Arbyn M,

Bosch FX, Cuzick J, Dillner J, Heideman DA, Snijders PJ. Guidelines for human

papillomavirus DNA test requirements for primary cervical cancer screening in

women 30 years and older. Int J Cancer. 2009 Feb 1;124(3):516-20. doi:

10.1002/ijc.24010. PubMed PMID: 18973271; PubMed Central PMCID: PMC2789446.

Now the European Guidelines updated this part:

http://bookshop.europa.eu/en/european-guidelines-for-quality-assurance-in-cervical-cancer-screening-pbEW0115451/;pgid=Iq1Ekni0.1lSR0OOK4MycO9B0000Sy9siJY5;sid=VsQueJsoATsufs2Hw7ew3_kN9AdSKDnrKpQ=?CatalogCategoryID=OG4KABst1uEAAAEjnZAY4e5L

To have an idea of which tests have been validated up to date you can see this paper:

Arbyn M, Snijders PJ, Meijer CJ, Berkhof J, Cuschieri K, Kocjan BJ, Poljak M.

Which high-risk HPV assays fulfil criteria for use in primary cervical cancer

screening? Clin Microbiol Infect. 2015 Sep;21(9):817-26. doi:

10.1016/j.cmi.2015.04.015. Epub 2015 May 1. Review. PubMed PMID: 25936581.

The prices are now quite low for high volume laboratories (in Italy some regions obtained about 4.5-5 euros per screened woman, VAT excl). Actually all these tenders have been adjudicated by Roche (with Cobas) and Qiagen (with HCII). The number of test per lab/year is about 50,000, but we cannot exclude that other competitors will appear on the market or that some of the producers will make more competitive bids.

If you are not going to use the typing for women management (i.e. your management is based only on cytology) all the validated tests are good. If you need partial typing (i.e. distinguishing 16 and/or 18 from the other) HCII is not good enough. In a population with high prevalence of lesions that has not been already intensively screened, the positive predictive value of HPV 16 is similar to the PPV of other high risk types (there are not too many studies about this and it is difficult to find references, but there is some indirect evidence). So I do not suggest to use data from the USA to estimate the efficiency of typing as triage test.

@Paolo, Thank you for the informative answer

Thank you all for the added information