New technique could enhance cervical cancer screening
Cervical cancer is a type of cancer that occurs in the cells of the cervix, the lower part of the uterus that connects to the vagina. PHOTO|SHUTTERSTOCK
What you need to know:
- The study carried out in primary care centres in England, involved 855 women who tested positive for HPV with a self-test, suggesting they had HPV infections, and also had a follow-up test by a doctor.
- The results showed that 71 of these women (8.3 per cent) had severe cervical pre-cancer or cancer
A new study has shown that analysing self-tests for human papillomavirus (HPV) can help classify HPV-positive women into three risk groups, a method that could improve cervical cancer screening.
The research conducted by Karolinska Institutet and Queen Mary University of London published in PLOS Medicine, was based on British women who were offered a self-test for HPV in a trial because they were overdue for their cervical cancer screening.
The study carried out in primary care centres in England, involved 855 women who tested positive for HPV with a self-test, suggesting they had HPV infections, and also had a follow-up test by a doctor. The results showed that 71 of these women (8.3 per cent) had severe cervical pre-cancer or cancer.
The researchers analysed the results of the self-sample HPV tests and used a new method to assess the risk of severe cellular changes. The risk was determined based on the type of HPV virus and the amount of virus (measured by the cycle threshold, Ct value) in the self-test. They grouped the women into three risk categories: high, medium, and low. Women with HPV type 16 and a low cycle threshold (Ct) value of less than 30 had the highest risk of severe cervical precancer or cancer.
"About 40 per cent of women in our high-risk group were diagnosed with severe cervical precancer or cancer that requires treatment. Therefore, we recommend that this group be referred directly for further investigation with colposcopy," says Jiayao Lei, Lei, assistant professor at the Department of Medical Epidemiology and Biostatistics and Department of Clinical Science, Intervention and Technology, who is the lead author of the study.
More than half of the women who tested positive were in the low-risk group, with only a 4 per cent chance of being diagnosed with severe cervical pre-cancer or cancer within 12 months.
"We believe it is safe for the low-risk group to be retested after 12 months, while the moderate-risk group should be encouraged to see a clinician for testing," says the study's senior author, Peter Sasieni, Professor at Queen Mary University of London.
One of the key benefits of the new method is that the risk assessment can be done immediately after the HPV self-test, without additional laboratory tests.
According to Jiayao, self-testing for HPV has become an important component of cervical screening, because it reaches women who would not otherwise participate.
"This could be especially valuable for cervical cancer screening in low- and middle-income countries, where resources are limited," says Peter Sasieni.
[email protected]
