Caution urged over planned introduction of new cervical screening test

March 11, 2016, University of Otago

The Minister of Health's announcement of the introduction within two years of a new test for cervical cancer to replace the current screening method poses a risk to "our well-established, high-quality" screening programme, say leading New Zealand experts and researchers in the New Zealand Medical Journal (NZMJ) this week.

The NZMJ editorial by a group of concerned specialists and researchers, including University of Otago Associate Professor and cancer researcher Brian Cox, says the group believes the National Screening Unit will recommend to the Minister of Health that the current screening test for cervical cancer be changed from liquid-based cytology to a molecular based human papillomavirus (HPV) test in 2018.

"We believe that while primary HPV screening shows promise.... implementation in New Zealand in 2018 is premature and wrong. This decision could reduce the current level of cervical cancer protection and increase unnecessary referrals for assessment and treatment," say the authors, led by prominent Dunedin cytopathologist Peter Fitzgerald.

"The potential for physical and psychological cost to women is unknown. Financial projections suggesting savings for the Government are optimistic and the proposed change may cost more. The public sector colposcopy ( testing) services are currently stressed and unlikely to meet future demand without considerable extra resourcing."

The article adds that there is potential for over-treatment using the proposed new system, and this could harm women.

"There is no debate about whether or not there will be extra colposcopy referral, diagnostic biopsies and treatments as a result of primary HPV (testing) compared to current cytology screening. The debate is only around how much extra and whether the New Zealand health service can cope with the increased demand for these services," the authors say.

"Without a considerable increase in already stressed colposcopy resources, waiting times for colposcopy are likely to increase considerably when HPV testing is introduced. Because of this, we believe it is possible the primary HPV new screening algorithm may cost the Government more than it currently spends on cervical screening."

They believe that the uncertainty and transition-risk could be avoided by co-testing with both cytology and HPV screening.

The recommendation to change the system in New Zealand was based on international clinical trial evidence and population-based modelling, but there has been no data available on this new method of HPV-screening's performance in national cervical screening programmes.

In the United Kingdom, for example, pilot studies have been set up to determine whether such screening was effective, safe and logistical. In New Zealand, no such pilot studies have guided the decision.

"Where practicable, health service observations of the effects of potential changes in screening policy are strongly advised…. (in New Zealand) the safety of HPV testing at extended intervals is not certain," the article states.

Explore further: ACOG: New recommendations for cervical cancer screening

Related Stories

ACOG: New recommendations for cervical cancer screening

December 23, 2015
(HealthDay)—In a practice bulletin published in the January issue of Obstetrics & Gynecology, new recommendations are presented for cervical cancer screening and prevention.

Longer screening intervals possible with HPV-based tests

January 21, 2014
A new study from Karolinska Institutet in Sweden finds that testing for human papilloma virus (HPV) allows for longer time between screening tests when compared to cytology-based testing. The study is published in the scientific ...

Multiple strategies are more efficient for cervical cancer

March 30, 2013
(HealthDay)—Multiple cervical cancer screening strategies that maximize early detection of high-grade disease without excessive increases in initial testing appear to be most effective, according to a study published in ...

Researchers publish on connection between anal cancer, HPV

February 17, 2016
Researchers at Women & Infants Hospital, a Care New England hospital, recently published the results of a study demonstrating a connection between anal cancer and human papillomavirus (HPV) infection.

HPV testing could cut cervical cancers by a third

June 14, 2013
(Medical Xpress)—Testing women for the human papillomavirus (HPV) first, instead of using the traditional cervical screening test to detect abnormal cells in the cervix, could prevent around 600 cases of cervical cancer ...

Sigmoidoscopy bowel-screening method promises reductions in mortality and risk

March 9, 2016
An effective national bowel screening programme involving a single test, a sigmoidoscopy, could be introduced in New Zealand within 12 months.

Recommended for you

From the ashes of a failed pain drug, a new therapeutic path emerges

November 16, 2018
In 2013, renowned Boston Children's Hospital pain researcher Clifford Woolf, MB, BCh, Ph.D., and chemist Kai Johnsson, Ph.D., his fellow co-founder at Quartet Medicine, believed they held the key to non-narcotic pain relief. ...

Repurposing FDA-approved drugs can help fight back breast cancer

November 16, 2018
Screening Food and Drug Administration (FDA)-approved compounds for their ability to stop cancer growth in the lab led to the finding that the drug flunarizine can slow down the growth of triple-negative breast cancer in ...

Traditional chemotherapy superior to new alternative for oropharyngeal cancers

November 16, 2018
A drug increasingly used in combination with radiotherapy to treat a type of cancer that forms in the tonsils or the base of the tongue is inferior to a previously favored option, according to a large, clinical trial led ...

New 'SLICE' tool can massively expand immune system's cancer-fighting repertoire

November 15, 2018
Immunotherapy can cure some cancers that until fairly recently were considered fatal. In addition to developing drugs that boost the immune system's cancer-fighting abilities, scientists are becoming expert at manipulating ...

Standard chemotherapy treatment for HPV-positive throat cancer remains the most effective, study finds

November 15, 2018
A new study funded by Cancer Research UK and led by the University of Birmingham has found that the standard chemotherapy used to treat a specific type of throat cancer remains the most effective.

Anti-malaria drugs have shown promise in treating cancer, and now researchers know why

November 15, 2018
Anti-malaria drugs known as chloroquines have been repurposed to treat cancer for decades, but until now no one knew exactly what the chloroquines were targeting when they attack a tumor. Now, researchers from the Abramson ...

1 comment

Adjust slider to filter visible comments by rank

Display comments: newest first

not rated yet Mar 17, 2016
There is plenty of evidence to show HPV primary testing, used the right way, will save more lives and takes most women out of pap testing and harms way. (false positives, excess biopsies and over-treatment)
It's important for independent people and groups to review the evidence and make the necessary changes to the program, doing what's best for women.
I've watched the Dutch for many years, they don't allow vested interests to control their programs, they don't waste scarce health resources and they follow the evidence. They offer 5 HPV primary tests or HPV self-testing at ages 30,35,40,50 and 60 and only the roughly 5% who test HPV+ will be offered a 5 yearly pap test. This is evidence based screening.
HPV Today, Edition 24, sets out the Dutch program.
I don't screen, an informed decision, initially, I didn't like the numbers with the Aussie program, 0.65% lifetime risk of cc v 77% lifetime risk of colposcopy and biopsy, now I know HPV- women cannot benefit from testing

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.