HPV screen-and treat-intervention effective in cervical cancer prevention

September 30, 2010, Journal of the National Cancer Institute

Women in South Africa who underwent human papillomavirus (HPV) DNA-based testing or visual inspection of the cervix followed by treatment of test-positive women with cryotherapy had a statistically significant reduction in high grade cervical cancer precursors, compared with women in a control group, according to a study published online Sept. 30 in The Journal of the National Cancer Institute.

In many developing countries, especially in sub-Saharan Africa, cytology-based screening is unavailable. To counter this lack of availability, non-cytological screening methods such as DNA testing or visual inspection of the cervix have been developed, methods that do not require the same laboratory infrastructure as cytology and allow for the immediate treatment of women with detected lesions. The approach of screening using non-cytological methods and then treating all test positive women is referred to as "screen-and-treat" and access to such prevention programs may be able to reduce cervical cancer mortality where cytology-based screening is unavailable.

To determine whether HPV DNA-based screening and visual inspection of the cervix reduced cervical cancer, Thomas C. Wright, M.D., of Columbia University, and colleagues, conducted a randomized trial of 6637 unscreened South African women aged 35-56 years, who were assigned to three study arms: HPV DNA screen-and-treat, in which women with a positive HPV test, VIA screen-and-treat in which women with a positive visual inspection test underwent cryotherapy; or a control group, in which further evaluation and treatment were delayed for 6 months. The researchers tested the women for 36 months, and measured cervical cancer lesions of grade two or worse, also known as CIN 2+ for cervical intraepithelial neoplasia.

The researchers found that after 36 months of follow-up, the women who developed CIN2+ included 1.5% in the screen-and-treat arm, 3.8% in the visual inspection-and-treat arm, and 5.6% in the control arm. The authors write, "This study demonstrates that an HPV DNA-based screen-and-treat program for cervical cancer is highly effective and produces a durable reduction in CIN 2+."

Furthermore, they write: "These results suggest that cryotherapy may have long-term implications for low-resource settings where it is difficult and costly to re-screen women at regular intervals."

In an accompanying editorial, Julia C. Gage and Philip E. Castle of the National Cancer Institute write that the advent of accurate low-cost HPV bodes well for in low-income settings—provided political will and monetary investment accompany technological advancement. "With low-cost accurate HPV tests coming online, cervical is becoming more effective, affordable, and feasible for low-resource settings," they write.

Related Stories

Recommended for you

Single blood test screens for eight cancer types

January 18, 2018
Johns Hopkins Kimmel Cancer Center researchers developed a single blood test that screens for eight common cancer types and helps identify the location of the cancer.

Researchers find a way to 'starve' cancer

January 18, 2018
Researchers at Vanderbilt University Medical Center (VUMC) have demonstrated for the first time that it is possible to starve a tumor and stop its growth with a newly discovered small compound that blocks uptake of the vital ...

How cancer metastasis happens: Researchers reveal a key mechanism

January 18, 2018
Cancer metastasis, the migration of cells from a primary tumor to form distant tumors in the body, can be triggered by a chronic leakage of DNA within tumor cells, according to a team led by Weill Cornell Medicine and Memorial ...

Modular gene enhancer promotes leukemia and regulates effectiveness of chemotherapy

January 18, 2018
Every day, billions of new blood cells are generated in the bone marrow. The gene Myc is known to play an important role in this process, and is also known to play a role in cancer. Scientists from the German Cancer Research ...

These foods may up your odds for colon cancer

January 18, 2018
(HealthDay)—Chowing down on red meat, white bread and sugar-laden drinks might increase your long-term risk of colon cancer, a new study suggests.

The pill lowers ovarian cancer risk, even for smokers

January 18, 2018
(HealthDay)—It's known that use of the birth control pill is tied to lower odds for ovarian cancer, but new research shows the benefit extends to smokers or women who are obese.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.