Primary HPV screening provides 60-70 percent greater protection against invasive cervical cancer than cytology-based screeningNovember 02, 2013
Cervical screening aims to prevent invasive cervical cancer by detecting abnormalities in a woman's cervix which can be a precursor to cancer. In cytology-based screening, the cells taken during the test are examined under a microscope to detect changes. In HPV-based screening, the cells are initially tested for the presence of HPV, a common, and usually harmless, viral infection which can in some cases cause the abnormalities in the cervix which can precede cancer. In both cases, if cell changes or HPV are detected, the patient is notified, and undergoes further screening and examination, followed by treatment, if needed.
A team of researchers led by Dr Guglielmo Ronco, from the Center for Cancer Epidemiology and Prevention in Turin, Italy, analysed data from four major European trials in England, Italy, the Netherlands, and Sweden  which compared HPV-based screening with cytology-based screening. In all of the trials, researchers examined the effectiveness of HPV or cytological screening in detecting precursors for treatment to prevent progression to cancer. However, until now, no study could provide reliable estimates of the effectiveness of HPV versus cytological screening in protecting against invasive cervical cancer.
By following-up for an average of 6•5 years more than 175 000 women aged 20-64 who participated in the four trials, the researchers were able to show that detection of invasive cancers was similar between screening methods for the first 2•5 years after the trials began. Thereafter, fewer cancers were detected in women who had undergone HPV screening, with the researchers calculating that HPV-based screening protected 60-70% more women from invasive cervical cancer than did cytology-based screening.
Despite the fact that each of the trials included in the analysis used different screening protocols, the efficacy of HPV testing was not notably different across the trials. Moreover, the results show that increased protection against invasive cervical cancer was especially notable in women aged 30-35 years, and HPV screening every 5 years was most protective against invasive cancers of the cervix, compared with cytology done every 3 years.
According to Dr Ronco, "Until now, there have been no direct estimates of the relative efficacy of HPV-based versus cytology-based screening for prevention of invasive cancer in women who undergo regular screening, of how variables like age affect this efficacy, and of the duration of protection. Our analysis shows that HPV-based screening appears to prevent more invasive cervical cancers than does cytology, and on this basis, we recommend implementation of HPV-based cervical screening with triage from age 30 years at intervals of at least 5 years. Triage means that HPV positive women have a follow-up cytology test (reflex cytology) and only those with abnormal cytology or persistent HPV infection go on to have colposcopy (a close examination of the cervix using a magnifying instrument called a colposcope)."*
In a linked Comment, Sandra Isidean and Eduardo Franco of McGill University in Montreal, Canada, write that, "The future of cervical cancer screening in high-resource settings will most probably incorporate primary HPV testing, a science-driven change in strategy that particularly befits the post-HPV vaccination era. With economies of scale that come with broad implementation of primary HPV testing (which will foster competition among various HPV tests) and the lengthening of screen intervals, cervical cancer screening might end up costing countries less money while providing greater safety than with conventional cervical cytology. To reap the benefits of this implementation, however, nations will need to consider important logistical challenges, including: settling on the type of HPV screening test to be used; ascertaining appropriate screening ages and intervals; defining triage and management policies for HPV-positive women; and ensuring quality of and adherence to revised policies."
The results will be presented at EUROGIN 2013, one of the largest fora worldwide for clinicians interested in cervical cancer control and HPV-associated diseases.
 The trials included in the analysis were: Swedescreen (Sweden), POBASCAM (the Netherlands), ARTISTIC (England), and NTCC (Italy).
* Quote direct from author and cannot be found in text of Article
Related Cancer Articles:
East Asian female breast cancer patients receiving radiotherapy have a higher risk of developing second primary lung cancer.
Continuing PLOS Medicine's special issue on cancer genomics, Christos Hatzis of Yale University, New Haven, Conn., USA and colleagues describe a new subtype of triple negative breast cancer that may be more amenable to treatment than other cases of this difficult-to-treat disease.
Osaka University researchers revealed that the metabolite D-2-hydroxyglurate (D-2HG) promotes epithelial-mesenchymal transition of colorectal cancer cells, leading them to develop features of lower adherence to neighboring cells, increased invasiveness, and greater likelihood of metastatic spread.
University of Hawai'i Cancer Center researchers have identified an essential driver of tumor cell invasion in glioblastoma, the most aggressive form of brain cancer that can occur at any age.
University of Hawai'i Cancer Center researchers developed a computational algorithm to analyze 'Big Data' obtained from tumor samples to better understand and treat cancer.
University of Oklahoma researchers will apply a new analytical technology that could ultimately provide a powerful tool for improved treatment of cancer patients in Oklahoma and beyond.
Researchers have found that treating patients who have early stage non-small cell lung cancer with a type of radiotherapy called stereotactic body radiation therapy is associated with a small but increased risk of death from causes other than cancer.
Is investment in research to develop new treatments the best approach to controlling cancer?
The University of Illinois Cancer Center and Governors State University have received a joint four-year, $1.5 million grant from the National Cancer Institute to help both institutions conduct community-based research to reduce cancer-related health disparities in Chicago's south suburbs.
The Cancer Research Institute, the Association for Cancer Immunotherapy, the European Academy of Tumor Immunology, and the American Association for Cancer Research will join forces to sponsor the first International Cancer Immunotherapy Conference at the Sheraton New York Times Square Hotel in New York, Sept.
Related Cancer Reading:
The Cancer-Fighting Kitchen, Second Edition: Nourishing, Big-Flavor Recipes for Cancer Treatment and Recovery
by Rebecca Katz (Author), Mat Edelson (Author)
This new and revised edition of the IACP award-winning cookbook brings the healing power of delicious, nutritious foods to those whose hearts and bodies crave a revitalizing meal, through 150 new and updated recipes.
Featuring science-based, nutrient-rich recipes that are easy to prepare and designed to give patients a much-needed boost by stimulating appetite and addressing treatment side effects including fatigue, nausea, dehydration, mouth and throat soreness, tastebud changes, and weight loss. A step-by-step guide helps patients nutritionally prepare for all phases of... View Details
The Truth about Cancer: What You Need to Know about Cancer's History, Treatment, and Prevention
by Ty M Bollinger (Author)
Cancer touches more lives than you may think. According to the World Health Organization, one out of three women alive today, and one out of two men, will face a cancer diagnosis in their lifetime.
To Ty Bollinger, this isn’t just a statistic. It’s personal. After losing seven members of his family to cancer over the course of a decade, Ty set out on a global quest to learn as much as he possibly could about cancer treatments and the medical industry that surrounds the disease. He has written this book to share what he’s uncovered—some of which may shock you—and to give you... View Details
Anticancer: A New Way of Life
by David Servan-Schreiber MD PhD (Author)
The revolutionary, New York Times bestselling guide to the powerful lifestyle changes that fight and prevent cancer—an integrative approach based on the latest scientific research
“A common-sense blueprint for healthy living.” —Chicago Tribune
“Resonating with cancer support communities and recommended nationwide.” —Los Angeles Times
“Life affirming . . . filled with practical advice.” —The Seattle Times
David Servan-Schreiber was a rising... View Details
The Metabolic Approach to Cancer: Integrating Deep Nutrition, the Ketogenic Diet, and Nontoxic Bio-Individualized Therapies
by Dr. Nasha Winters ND FABNO L.Ac Dipl.OM (Author), Jess Higgins Kelley MNT (Author), Kelly Turner (Foreword)
The Optimal Terrain Ten Protocol to Reboot Cellular Health
Since the beginning of the twentieth century, cancer rates have increased exponentially―now affecting almost 50 percent of the American population. Conventional treatment continues to rely on chemotherapy, surgery, and radiation to attack cancer cells. Yet research has repeatedly shown that 95 percent of cancer cases are directly linked to diet and lifestyle. The Metabolic Approach to Cancer is the book we have been waiting for―it offers an innovative, metabolic-focused nutrition protocol that... View Details
F*ck Cancer: A totally inappropriate self-affirming adult coloring book (Totally Inappropriate Series) (Volume 4)
by Jen Meyers (Author)
*A portion of the proceeds from this book will be donated to support research dedicated to finding a cure for cancer. Because fuck cancer.
This book is for you.
If you are fighting cancer, this is for you. If your brother, sister, mom, dad, son, daughter, relative, or friend is fighting cancer, this is for you. If you've lost someone to cancer like I have, this is for you. If cancer affects your life in any way, this is for you.
The stress of cancer can feel crushing. But perhaps this book can help you get away from it all, if only for a little... View Details
Tripping over the Truth: How the Metabolic Theory of Cancer Is Overturning One of Medicine's Most Entrenched Paradigms
by Travis Christofferson (Author), Dominic D'Agostino (Foreword)
With a new foreword by Dr. Dominic D'Agostino, PhD and epilogue by the author
A masterful synchronization of history and cutting-edge science shines new light on humanity's darkest diagnosis.
In the wake of the Cancer Genome Atlas project's failure to provide a legible roadmap to a cure for cancer, science writer Travis Christofferson illuminates a promising blend of old and new perspectives on the disease. Tripping over the Truth follows the story of cancer’s proposed metabolic origin from the vaunted halls of the German scientific golden age to... View Details
Cancer Hates Tea: A Unique Preventive and Transformative Lifestyle Change to Help Crush Cancer
by Maria Uspenski (Author), Dr. Mary L. Hardy (Foreword)
Drink Tea to Tell Cancer ‘Hit the Road’
Become a tea lover with a purpose and help your body defend itself against cancer. Learn to embrace tea in all its varieties― green, white, black, pu-erh, herbal and more―as both a mental and physical experience to protect your health. Discover the history, growing information and health implications of each variety, as well as uniquely delicious methods to boost your intake with serving suggestions, food pairings and recipes that highlight the benefits of tea.
After her own battle with cancer, Maria Uspenski extensively... View Details
Cancer: 50 Essential Things to Do: 2013 Edition
by Greg Anderson (Author)
The ground-breaking classic guide to surviving cancer?now completely updated!
Revised and updated for the first time since 1999, this invaluable guide to cancer recovery offers an easily accessible plan for patients and family members. Written by a cancer survivor, the book is an inspiring, action-oriented roadmap for those who choose to adopt a stance of hope and take charge of their diagnosis.
With penetrating insights that bring together more than two decades of scientifically supported research and experience, Anderson reveals a step-by-step holistic action plan... View Details
Beating Cancer with Nutrition (Fourth Edition) Rev
by Patrick Quillin (Author)
There is good news in the "war on cancer". Optimal nutrition coupled with appropriate medical treatment can dramatically improve the quality and quantity of life and chances for a complete remission for most cancer patients. A well-nourished cancer patient can better manage the disease. Cancer is the number two cause of death in America and the developed nations of the world with one out of four dying from cancer and 38% of women and 43% of men projected to develop cancer over their lifetime. While the overall death rate from cancer has not appreciably declined since... View Details
Living with Cancer: A Step-by-Step Guide for Coping Medically and Emotionally with a Serious Diagnosis (A Johns Hopkins Press Health Book)
by Vicki A. Jackson MD MPH (Author), David P. Ryan MD (Author), Michelle D. Seaton (Author)
The prospect of entering treatment is overwhelming for anyone facing a diagnosis of cancer. While patients have access to a vast amount of medical information online, this advice is often unreliable or confusing. In Living with Cancer, Drs. Vicki A. Jackson and David P. Ryan have crafted the first step-by-step guide aimed at helping people with this life-defining disease grasp what’s happening to them while coping physically and emotionally with cancer treatment.
An empathetic resource full of relatable patient stories, this book teaches patients and caregivers how to ask... View Details