{"entity":{"id":"paper-canfell-compass-pilot-plos-med-2017","kind":"paper","name":"Cervical screening with primary HPV testing or cytology in a population of women in which those aged 33 years or younger had previously been offered HPV vaccination: results of the Compass pilot randomised trial","aka":[],"tldr":"The first randomised test of HPV-based cervical screening in a country that had already vaccinated its young women. HPV testing found more precancer than the smear test did.","summary":"Compass is an open-label randomised trial of five-yearly HPV screening against two-and-a-half-yearly liquid-based cytology. In its pilot, women aged 25 to 64 attending 47 primary care practices in Victoria between October 2013 and November 2014 were randomised 1:2:2 to cytology with HPV triage of low-grade results, HPV screening with cytology triage, or HPV screening with dual-stained cytology triage; in both HPV arms women positive for HPV16 or 18 went straight to colposcopy. By 2014 resident women aged 33 or younger had been age-eligible for HPV vaccination, with three-dose uptake of about 50 to 77 percent across cohorts.\n\nOf 4,995 women analysed, detected CIN2+ was 1/995 (0.1 percent) with cytology, 20/1,992 (1.0 percent) with HPV and cytology triage and 24/2,008 (1.2 percent) with HPV and dual-stain triage (p = 0.003 for cytology against HPV screening). Colposcopy referral was 2.7, 3.8 and 3.9 percent, a difference that was not statistically significant (p = 0.09).","asOf":"2026-11-03","links":[{"label":"PLoS Medicine 2017","url":"https://doi.org/10.1371/journal.pmed.1002388"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/28926579/"}],"tags":[],"related":[],"cancers":["cervical"],"sections":["prevention"],"technologies":["hpv-vaccine"],"targets":[],"drugs":[],"companies":[],"institutions":["acpcc"],"pathways":[],"terms":[],"trials":["compass-cervical-hpv-screening"],"people":["karen-canfell"],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"journal":"PLoS Medicine","year":2017,"doi":"10.1371/journal.pmed.1002388","pmid":"28926579","authors":"Canfell K, Caruana M, Gebski V, Darlington-Brown J, Heley S, Brotherton J, Gertig D, Jennett CJ, Farnsworth A, Tan J, Wrede CD, Castle PE, Saville M","paperType":"rct","findings":["4,995 women analysed after 11 withdrawals, from 5,006 recruited at 47 practices in Victoria between 29 October 2013 and 7 November 2014.","Detected CIN2+: 0.1% (1/995) with cytology, 1.0% (20/1,992) with HPV and cytology triage, 1.2% (24/2,008) with HPV and dual-stain triage; p = 0.003 for cytology against HPV screening.","Colposcopy referral: 2.7%, 3.8% and 3.9%; p = 0.09.","No serious trial-related adverse events."],"whatItMeans":"It was early randomised evidence that HPV testing still finds more precancer than cytology once a population is partly vaccinated, the question Australia had to answer before changing its national programme to HPV testing every five years.","caveats":["The authors note a relatively low-risk, previously well-screened population, unknown individual vaccination status, and no long-term follow-up yet of screen-negative women.","This is the pilot; the main Compass trial of 76,181 women is still in follow-up."],"participants":4995},"route":"/key-papers/paper-canfell-compass-pilot-plos-med-2017/","neighbours":{"cancer":[{"id":"cervical","kind":"cancer","name":"Cervical cancer","route":"/cancers/cervical/"}],"section":[{"id":"prevention","kind":"section","name":"Prevention & Risk","route":"/fronts/prevention/"}],"technology":[{"id":"hpv-vaccine","kind":"technology","name":"HPV & HBV vaccination","route":"/technologies/hpv-vaccine/"}],"institution":[{"id":"acpcc","kind":"institution","name":"Australian Centre for the Prevention of Cervical Cancer","route":"/institutions/acpcc/"}],"trial":[{"id":"compass-cervical-hpv-screening","kind":"trial","name":"Compass (primary HPV cervical screening trial)","route":"/trials/compass-cervical-hpv-screening/"}],"person":[{"id":"karen-canfell","kind":"person","name":"Karen Canfell","route":"/people/karen-canfell/"}]}}