There's a better way to screen for cervical cancer

April 11, 2018, Oxford University Press
High grade dysplasia (carcinoma in situ) in the uterine cervix. The abnormal epithelium is extending into a mucus gland to the left of centre. This disease can progress to invasive cancer (squamous cell carcinoma) of the cervix. Credit: Haymanj/public domain

A new study in the Journal of the National Cancer Institute, published by Oxford University Press, indicates that high-quality cervical cancer screening can be done effectively using a completely automated approach. The researchers involved in the study indicate that automated technology could increase cervical screening coverage in underserved regions.

Cervical cancer is caused by persistent infection with carcinogenic human papillomaviruses (HPV). HPV vaccination to control transmission is the ultimate prevention strategy; however, vaccination remains a long-term solution due to still-limited coverage and the long latency between infection and cancer development

The main goal of is to detect potentially premalignant conditions, which can be treated to prevent . Cervical screening programs include two procedures: screening of the general population and the separation of screen-positive to focus treatment on potentially premalignant conditions. For the general screening phase, HPV testing for the carcinogenic types of HPV is gradually replacing cytology (Pap testing), because HPV testing is more sensitive for detection of precancer malignancies. It is also more reproducible and adaptable to increasingly HPV-vaccinated populations.

The leading treatment strategy in higher-resource regions combines partial HPV typing (to identify the highest-risk types) and Pap tests (used in this case as a second among HPV-positive women). Conventional Pap tests, which are currently combined with HPV testing in most US screening programs to determine which women should receive treatment, is labor-intensive.

Use of computer-interpreted Pap tests for triage would permit the automation of the whole screening process. Here researchers report the design and evaluation of such a fully automatable cervical screening strategy to determine whether an automated algorithm could separate and prioritize HPV-positive women for treatment as accurately as conventionally interpreted Pap tests.

The researchers here developed a novel risk score algorithm based on computer-scanned liquid-based slide features to separate HPV-positive women to target potentially premalignant conditions using a slide scanner that performs a high-speed image capture to detect features of the Pap test slide such as the presence of different cell types, nuclear size, and nuclear contour. The severity rank is designed to identify the most innocuous slides in a batch, to reduce and/or guide treatment decisions.

Researchers compared it with abnormal Pap test results in predicting precancer among 1839 women testing HPV positive in 2010 at Kaiser Permanente Northern California. Precancer outcomes were ascertained by record linkage. As additional validation, they compared the algorithm with Pap test results among 243,807 women screened at Kaiser Permanente.

Among HPV-positive women, the algorithm matched the triage performance of abnormal Pap test results. Combined with HPV testing, the automated approach referred 91.7% of HPV-positive cases to immediate treatment while deferring 38.4% of HPV-positive women to one-year retesting (compared with 89.1% and 37.4%, respectively, for typing and Pap test triage). In the 2016-2017 validation, the predicted risk scores strongly correlated with Pap test results.

The results of this study showed that a computer algorithm matches or exceeds Pap test performance, suggesting that totally automated cervical screening without Pap tests is feasible and can improve cervical coverage in underserved regions.

Explore further: HPV testing is better than the Pap test at detecting cervical cancer

More information: "Automated Cervical Screening and Triage, Based on HPV Testing and Computer-Interpreted Cytology," Journal Of The National Cancer Institute (2018). DOI: 10.1093/jnci/djy044

Related Stories

HPV testing is better than the Pap test at detecting cervical cancer

November 14, 2017
A new paper in the Journal of the National Cancer Institute finds that testing for cervical cancer using HPV testing in addition to the Pap smear is unlikely to detect cancer cases that wouldn't be found using HPV testing ...

Self-sampling identifies twice as many women at risk of cervical cancer

February 15, 2018
Using self-sampling followed by HPV testing, more than twice as many women at risk of developing cervical cancer could be identified and offered preventive treatment. This is shown by researchers at Uppsala University in ...

Screening for cervical abnormalities in women offered HPV vaccination

September 19, 2017
Human papillomavirus (HPV) testing detects a higher number of precancerous cervical lesions than cytology-based Pap smears in a female population including a proportion offered HPV vaccination, according to a new study published ...

Screening, HPV vaccine can prevent cervical cancer: FDA

February 8, 2017
(HealthDay)—Women can reduce their risk of cervical cancer through vaccination and screening, the U.S. Food and Drug Administration says.

Facts women and men should know about cervical cancer

January 22, 2018
January is Cervical Cancer Awareness month and the message from the Centers from Disease Control and Prevention is that "no woman should die from cervical cancer."

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.

Recommended for you

Downward-facing mouse: Stretching reduces tumor growth in mouse model of breast cancer

May 22, 2018
Many cancer patients seek out gentle, movement-based stretching techniques such as yoga, tai chi and qigong, but does stretching have an effect on cancer? While many animal studies have attempted to quantify the effects of ...

Resetting the epigenetic balance for cancer therapy

May 22, 2018
Though mutations in a gene called MLL3 are common across many types of cancers, their relationship to the development of the disease has been unclear. Now, a Northwestern Medicine study has identified an epigenetic imbalance ...

Compound in citrus oil could reduce dry mouth in head, neck cancer patients

May 21, 2018
A compound found in citrus oils could help alleviate dry mouth caused by radiation therapy in head and neck cancer patients, according to a new study by researchers at the Stanford University School of Medicine.

Ice cream funds research showing new strategy against thyroid cancer

May 21, 2018
Anaplastic thyroid cancer is almost uniformly fatal, with an average lifespan of about 5 months after diagnosis. And standard treatment for the condition includes 7 weeks of radiation, often along with chemotherapy.

Bladder cancer model could pave the way for better drug efficacy studies

May 21, 2018
Understanding that not all bladder cancers are the same, researchers at the University of North Carolina Lineberger Comprehensive Cancer Center have created a tool that may help them to uncover why only a fraction of patients ...

Breath test breakthrough for early diagnosis of oesophageal and gastric cancer

May 18, 2018
A breath test can successfully detect oesophageal and gastric cancer and could be used as a first-line test for patients, say researchers.

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.