The article, whose lead author is Dunedin cytopathologist Dr Peter Fitzgerald, criticises the ‘‘undue haste'' of the National Screening Unit in pushing for the testing change. This week, Health Minister Jonathan Coleman announced that in 2018, the test will change from liquid-based cytology to human papillomavirus (HPV) screening.
Dr Coleman said the switch was expected to reduce cervical cancer deaths by 16% in unvaccinated women and 12% in vaccinated women.
But the editorial says the change would strain the health system through extra referrals for colposcopy and other procedures, and could lead to more cancer.
‘‘This decision could reduce the current level of cervical cancer protection and increase unnecessary referrals for assessment and treatment.
‘‘Primary HPV screening may harm women through excessive referral to colposcopy and consequent overtreatment.''
Women under 30 were the most likely to have to undergo unnecessary procedures.
‘‘There is no debate about whether or not there will be extra colposcopy referral, diagnostic biopsies and treatments as a result of primary HPV compared to current cytology screening.
‘‘The debate is only around how much extra and whether the New Zealand health service can cope with the increased demand for these services.''
Financial projections suggesting cost savings were optimistic, and the proposed change may actually cost more, the authors argue.
The uncertainty and risk could have been eliminated by a period of co-testing with both cytology and HPV.
‘‘The move to primary HPV testing, as proposed by the [National Screening Unit], is not merely a simple change of the primary laboratory test, but requires multiple changes to most aspects of cervical screening.
‘‘The detection of a sexually transmitted infection rather than a significant cytological abnormality is a major change in the aim of screening. This may reduce screening participation. Any reduction in screening coverage will reduce protection from cervical cancer.''
While HPV testing was backed by evidence, it had not yet been proven in a national cervical screening programme. And its safety level for extended interval testing was uncertain.
The editorial also criticised the consultation process that led up to this week's decision, saying it was inadequate and had not given enough time for feedback.
The editorial was written by a group of specialists and researchers led by Dr Fitzgerald.
