Nav: Home

Primary HPV screening provides 60-70 percent greater protection against invasive cervical cancer than cytology-based screening

November 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 [1] 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.
-end-
NOTES TO EDITORS:

[1] 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

Lancet

Related Cancer Articles:

Radiotherapy for invasive breast cancer increases the risk of second primary lung cancer
East Asian female breast cancer patients receiving radiotherapy have a higher risk of developing second primary lung cancer.
Cancer genomics continued: Triple negative breast cancer and cancer immunotherapy
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.
Metabolite that promotes cancer cell transformation and colorectal cancer spread identified
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.
UH Cancer Center researcher finds new driver of an aggressive form of brain cancer
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.
UH Cancer Center researchers develop algorithm to find precise cancer treatments
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.
New analytical technology to quantify anti-cancer drugs inside cancer cells
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.
Radiotherapy for lung cancer patients is linked to increased risk of non-cancer deaths
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.
Cancer expert says public health and prevention measures are key to defeating cancer
Is investment in research to develop new treatments the best approach to controlling cancer?
UI Cancer Center, Governors State to address cancer disparities in south suburbs
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.
Leading cancer research organizations to host international cancer immunotherapy conference
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:

Anticancer: A New Way of Life
by David Servan-Schreiber MD PhD (Author)

The Emperor of All Maladies: A Biography of Cancer
by Siddhartha Mukherjee (Author)

The Truth about Cancer: What You Need to Know about Cancer's History, Treatment, and Prevention
by Ty M Bollinger (Author)

The Cancer-Fighting Kitchen, Second Edition: Nourishing, Big-Flavor Recipes for Cancer Treatment and Recovery
by Rebecca Katz (Author), Mat Edelson (Author)

The Cancer Revolution: A Groundbreaking Program to Reverse and Prevent Cancer
by Leigh Erin Connealy (Author)

F*ck Cancer: A totally inappropriate self-affirming adult coloring book (Totally Inappropriate Series) (Volume 4)
by Jen Meyers (Author)

Radical Remission: Surviving Cancer Against All Odds
by Kelly A. Turner PhD (Author)

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)

Cancer: 50 Essential Things to Do: 2013 Edition
by Greg Anderson (Author)

Outside the Box Cancer Therapies: Alternative Therapies That Treat and Prevent Cancer
by Dr. Mark Stengler (Author), Dr. Paul Anderson (Author)

Best Science Podcasts 2018

We have hand picked the best science podcasts for 2018. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

Why We Hate
From bullying to hate crimes, cruelty is all around us. So what makes us hate? And is it learned or innate? This hour, TED speakers explore the causes and consequences of hate — and how we can fight it. Guests include reformed white nationalist Christian Picciolini, CNN commentator Sally Kohn, podcast host Dylan Marron, and writer Anand Giridharadas.
Now Playing: Science for the People

#482 Body Builders
This week we explore how science and technology can help us walk when we've lost our legs, see when we've gone blind, explore unfriendly environments, and maybe even make our bodies better, stronger, and faster than ever before. We speak to Adam Piore, author of the book "The Body Builders: Inside the Science of the Engineered Human", about the increasingly amazing ways bioengineering is being used to reverse engineer, rebuild, and augment human beings. And we speak with Ken Thomas, spacesuit engineer and author of the book "The Journey to Moonwalking: The People That Enabled Footprints on the Moon" about...