Virus testing best for cervical cancer screening
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An analysis of data for more than 60,000 women in North America and Europe suggests that testing for human papillomavirus (HPV) may be the best way to screen for cervical cancer.
Numerous reports have linked certain subtypes of HPV with the lesions that precede cervical cancer. Findings from individual studies have suggested that for initial screening, HPV testing is more sensitive than cytology, which involves an analysis of cervical cells taken during a Pap smear. However, firm conclusions could not be reached, due in part to differences in design between the studies.
In the current study, Dr. Jack Cuzick, from the Queen Mary School of Medicine in London, and colleagues analyzed data from all European and North American studies that included routine cytology and additional HPV testing as a parallel test.
The findings appear in the International Journal of Cancer.
HPV testing detected 96 percent of “high-grade” cervical lesions that are at risk for becoming cancerous. By contrast, cytology only detected 53 percent.
The authors also found that HPV testing was very good at detecting these lesions regardless of the geographic region, whereas high variability was seen with cytology.
Similarly, HPV testing performed equally well in all age groups, whereas cytology performed much better in women over 50 years than in younger women.
“While well-conducted screening programs based on cytology have undoubtedly led to a large reduction of cervical cancer in some countries, the high variability in sensitivity reported here indicates the need for strict quality control,” the authors emphasize. “HPV testing is highly reproducible, more easily monitored, provides an objective test outcome and can be easily automated.”
SOURCE: International Journal of Cancer, April 3rd online issue 2006.
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