Gynaecologists have flagged concerns that the switch to HPV DNA-based cervical screening means some rare cases of cancer or pre-cancerous lesions could be missed.

They have published a case series of three asymptomatic Australian women who returned negative HPV test results despite having high-grade abnormalities detected on cytology. Two cases were later found to be positive for HPV 53, classed as a ‘probable’ oncogenic subtype by WHO.

Research suggests HPV 53 is on the rise in Australia, but it is not included in the test used for the National Cervical Screening Program (NCSP), say the gynaecologists, from Monash Medical Centre in Melbourne.

“The NCSP HPV screening includes the 12 oncogenic HPV types and two probably oncogenic subtypes; should this be expanded to include them all?” they wrote.