Repeat HPV Test Improves Specificity of Cervical Screening

Repeat testing for high-risk human papillomavirus (HPV) using self-sampling of vaginal fluid may increase specificity of cervical cancer screening and reduce unnecessary treatment in women aged 30 to 65 years, according to the results of a prospective study reported in the August issue of theBritish Journal of Cancer. Testing for high-risk [HPV] in primary screening for cervical cancer is considered more sensitive, but less specific, in comparison with [Papanicolaou]-smear cytology. Women with persistent HPV infections have a higher risk of developing cervical intraepithelial neoplasia 2+ (CIN2+) lesions.

The study goal was to assess the improvement in specificity for detecting histologically confirmed CIN2+ lesions associated with short-time repeat testing for high-risk HPV in women aged 30 to 65 years, using self-sampling to obtain the primary sample for HPV analysis. Of 8000 women aged 30 to 65 years who had not attended organized screening for at least 6 years, 8% (669) could not be contacted or had undergone hysterectomy. The rest of the women were offered self-sampling of vaginal fluid at home, and the samples were sent for HPV typing. About 3 months after the initial HPV test, women who tested positive for high-risk HPV in the self-sampling test were asked to undergo a follow-up HPV test and a cervical biopsy.

This study provides valuable additional data which can help inform improvements in the cervical screening programme in future — especially when screening will be increasingly taken up by women who have been vaccinated against HPV. It’s important that we reduce the number of women going through unnecessary procedures so that we can minimise any associated anxiety, and also make colposcopy services and screening more efficient. Read more…



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