The Evidence for Co-testing

Clinical data demonstrate that co-testing with Pap and HPV ordered together on the same accession provides the best protection against ≥CIN3 and cervical cancer for women ages 30 to 65, and recommendations from multiple leading health organizations support this conclusion. The results are in: co-testing is the most sensitive option for the most complete care. 

A landmark study from Quest Diagnostics HealthTrends™ used co-testing and cervical biopsy results to retrospectively compare Pap-alone testing, HPV-alone testing, and co-testing. The national study analyzed the de-identified data of approximately 8.6 million women ages 30 to 65 from thousands of clinical practices.1,2

  • Study population included 256,648 women who received both a co-test (Pap and HPV ordered together on the same accession) and cervical cancer biopsy performed by Quest Diagnostics within 1 year of each other
  • Visit to download a copy of the HealthTrends study by Blatt AJ, et al, from the May 2015 issue of Cancer Cytopathology

Learn more about the improved detection of ≥CIN3 and superior protection against cervical cancer that Pap and HPV testing offers, as well as the limitations of HPV-alone screening.


Dividing lineImproved detection of CIN3 and superior protection against cervical cancer
Co-testing missed the fewest cases of ≥CIN3 vs HPV-alone or Pap-alone testing.1,2

Percentage of missed by screening method

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Co-testing (Pap and HPV) had the fewest missed cases of cervical cancers in the same HealthTrends study

Percentage of missed cases of cervical cancers by screening method

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Limitations of HPV-alone screening

Numerous studies have shown screening with HPV alone misses cervical cancer in up to 31% of cases.1,2

Proportion of HPV cases chart

  • Clinical data from 10 published studies, including the Quest Diagnostics HealthTrends study, show that co-testing (Pap and HPV ordered together on the same accession) offers the best protection for your patients1,2


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1. Blatt AJ, Kennedy R, Luff RD, et al. Comparison of cervical cancer screening results among 256,648 women in multiple clinical practices. Cancer Cytopathology. 2015;123(5):282-288.

2. Quest Diagnostics. Data on file. 2015.