Evaluating the integration of molecular HPV testing into cervical cancer screening: a systematic literature review

Abstract

Introduction: Cervical cancer remains a leading cause of cancer-related mortality among women in Brazil. Although cytology-based screening has reduced incidence, its limited sensitivity restricts early detection. Molecular HPV testing has emerged as amore sensitive and cost-effective strategy, identifying high-grade precancerous lesions earlier. Objectives: This systematic literature review aimed to identify clinical and programmatic evidence supporting the adoption of HPV molecular testing as theprimary screening method for cervical cancer within Brazil’s Unified Health System (SUS). Methods: Articles published between 2019 and 2025 were retrieved from PubMed, Scielo, and Lilacs, selected according to PICO criteria and evaluated with the Joana Briggs Institute tool. Results: 11 articles were included that indicated higher sensitivity and negative predictive value of  HPV testingcompared to cytology, enabling extended screening intervals and greater protection against invasive disease. Conclusion: The findings justify the adoption of the molecular HPV test as an effective primary screening method for cervical cancer within the SUS, aligning Brazil with the recommendations of the Ministry of Health, international guidelines for the elimination of cervical cancer as a public health problem, and the global targets established by the World Health Organization.