Self-collection and HPV DNA testing could be an effective cervical cancer screening
Human papillomavirus (HPV) testing of self-collected specimens may be a more effective way to screen for cervical cancer in low-resource settings compared to visual inspection with acetic acid (VIA) and liquid-based cytology (LBC), according to a study published January 23 in the Journal of the National Cancer Institute.
Cervical cancer is the third most common cancer found in women with approximately 530,000 new cases each year resulting in an estimated 275,000 deaths. In developed countries, cervical cancer incidences have declined, mostly due to cervical cytology screening campaigns, which requires significant medical resources and laboratory infrastructure. Cervical cancer is on the rise in the developing world, with one-seventh of the world's cervical cancer cases in China, where there is no nationwide screening program for the disease yet. There, researchers have proposed that HPV testing of self-collected Pap specimens might serve as an alternative or complementary method of primary cervical cancer screening method.
In order to determine the effectiveness of HPV testing of self-collected Pap specimens (termed "Self-HPV testing" in the report), Professor You-Lin Qiao, M.D., Ph.D., of the Cancer Institute/Hospital at the Chinese Academy of Medical Sciences/Peking Union Medical College and colleagues, assembled individual patient data from five population-based cervical cancer-screening studies in China from 1999-2007, in which participants received HPV testing of self-collected Pap specimens, HPV testing of physician-collected Pap specimens, LBC, and VIA. The researchers then analyzed the pooled data to detect biopsy-confirmed cervical intraepithelial neoplasia grade 2 or more severe (CIN2+) or CIN3+. Of the 13,140 rural Chinese women screened for cervical cancer, 507 were diagnosed with CIN2+, 273 with CIN3+, and 37 with cervical cancer.
The researchers found that HPV testing of self-collected Pap specimens was more sensitive and less specific than VIA and LBC but less sensitive and similarly specific compared to physician-collected Pap specimens. They conclude that self-collection with HPV testing could help expand China's current screening outreach. "Although it is not specific enough to be a stand-alone test, self-HPV testing provides sensitive results without pelvic exams, medical professionals, or health-care facilities and thus has the potential to serve as a primary cervical cancer screening method for women, regardless of their geographic location or access to health care," the researchers write. Self-sampling procedures were instructed by medical professionals, and it is unclear whether unsupervised self-examinations would give out similar outcomes. Still, the researchers write, "The incorporation of Self-HPV testing in the Chinese government's planning of a national cervical cancer screening program would complement the current program by increasing its coverage of unscreened populations."
In an accompanying editorial, Patrick Petignat, M.D., of the University Hospitals of Geneva, writes that while HPV Self-Sampling for primary cervical cancer screening may help increase the number of women being screened, introducing a new screening method should be met with caution. He feels that determining both the cost effectiveness of the procedure as well as women's personal willingness to undergo self-screening is essential; furthermore, patients need to be properly educated about self-screening. "Efforts are still needed to increase awareness about HPV and cervical cancer, and more information is needed about the reliability of the method," Petignat writes. "Health-care professionals should provide sufficient support to participants to properly interpret their test results, thus avoiding any delay to follow-up and treatment."
Journal reference: Journal of the National Cancer Institute
Provided by Journal of the National Cancer Institute
- HPV testing followed by cytology and repeat HPV testing may improve cervical cancer screening Jan 13, 2009 | not rated yet | 0
- HPV testing prevents more invasive cervical cancers than cytology Jan 18, 2010 | not rated yet | 0
- Enabling women to use home test kits could increase HPV detection Mar 11, 2010 | not rated yet | 0
- HPV test detects more pre-cancerous cells than conventional smear test Apr 27, 2010 | not rated yet | 0
- Age-specific evaluation of HPV DNA testing vs. cytology screening Nov 10, 2009 | not rated yet | 0
- Motion perception revisited: High Phi effect challenges established motion perception assumptions Apr 23, 2013 | 3 / 5 (2) | 2
- Anything you can do I can do better: Neuromolecular foundations of the superiority illusion (Update) Apr 02, 2013 | 4.5 / 5 (11) | 5
- The visual system as economist: Neural resource allocation in visual adaptation Mar 30, 2013 | 5 / 5 (2) | 9
- Separate lives: Neuronal and organismal lifespans decoupled Mar 27, 2013 | 4.9 / 5 (8) | 0
- Sizing things up: The evolutionary neurobiology of scale invariance Feb 28, 2013 | 4.8 / 5 (10) | 14
Pressure-volume curve: Elastic Recoil Pressure don't make sense
May 18, 2013 From pressure-volume curve of the lung and chest wall (attached photo), I don't understand why would the elastic recoil pressure of the lung is...
If you became brain-dead, would you want them to pull the plug?
May 17, 2013 I'd want the rest of me to stay alive. Sure it's a lousy way to live but it beats being all-the-way dead. Maybe if I make it 20 years they'll...
MRI bill question
May 15, 2013 Dear PFers, The hospital gave us a $12k bill for one MRI (head with contrast). The people I talked to at the hospital tell me that they do not...
Ratio of Hydrogen of Oxygen in Dessicated Animal Protein
May 13, 2013 As an experiment, for the past few months I've been consuming at least one portion of Jell-O or unflavored Knox gelatin per day. I'm 64, in very...
Alcohol and acetaminophen
May 13, 2013 Edit: sorry for the typo in the title , can't edit I looked around on google quite a bit and it's very hard to find precise information on the...
Marie Curie's leukemia
May 13, 2013 Does anyone know what might be the cause of Marie Curie's cancer
- More from Physics Forums - Medical Sciences
More news stories
A new measure of the heterogeneity – the variety of genetic mutations – of cells within a tumor appears to predict treatment outcomes of patients with the most common type of head and neck cancer. In the May 20 issue ...
Cancer 51 minutes ago | not rated yet | 0
Researchers at Mayo Clinic have developed a promising method to distinguish between pancreatic cancer and chronic pancreatitis—two disorders that are difficult to tell apart. A molecular marker obtained from pancreatic ...
Cancer 1 hour ago | not rated yet | 0
The use of a smartphone application significantly improves patients' preparation for a colonoscopy, according to new research presented today at Digestive Disease Week (DDW). The preparation process, which begins days in ...
Cancer May 19, 2013 | not rated yet | 0
Research presented at Digestive Disease Week (DDW) explores new methods for managing digestive health through diet and lifestyle.
Cancer May 19, 2013 | not rated yet | 1
A ground-breaking advance in colonoscopy technology signals the future of colorectal care, according to research presented today at Digestive Disease Week(DDW). Additional research focuses on optimizing the minimal withdrawal ...
Cancer May 18, 2013 | 5 / 5 (2) | 0
Optimal treatment of sleep apnea in patients with prediabetes improves blood sugar (glucose) levels and thus can reduce cardiometabolic risk, according to a study to be presented at the ATS 2013 International Conference in ...
51 minutes ago | not rated yet | 0 |
Emergency physicians are key decisionmakers for nearly half of all hospital admissions, highlighting a critical role they can play in reducing health care costs, according to a new report from the RAND Corporation.
41 minutes ago | not rated yet | 0
Whole-cell pertussis vaccines were more effective at protecting against pertussis than acellular pertussis vaccines during a large recent outbreak, according to a new Kaiser Permanente study published in Pediatrics.
1 hour ago | not rated yet | 0 |
A novel study reports that white men and women of European descent inherit common foot disorders, such as bunions (hallux valgus) and lesser toe deformities, including hammer or claw toe. Findings from the Framingham Foot ...
1 hour ago | not rated yet | 0 |
Touted for safety, ease and patient convenience, peripherally inserted central catheters have become many clinicians' go-to for IV delivery of antibiotics, nutrition, chemotherapy, and other medications.
1 hour ago | not rated yet | 0
Scientists at Johns Hopkins have turned their view of osteoarthritis (OA) inside out. Literally. Instead of seeing the painful degenerative disease as a problem primarily of the cartilage that cushions joints, ...
14 hours ago | 4.8 / 5 (5) | 0 |