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HPV Test Improves Accuracy for Cervical Cancer Screening

A test for the human papilloma virus (HPV) appears to improve the accuracy in screening for cervical cancer compared to liquid-based cytology tests. These results were presented as a late-breaking abstract from the 2013 annual meeting of the Society of Gynecologic Oncology.

The majority of cervical cancers are attributed to an infection with HPV. The HPV “family” consists of hundreds of different types of viruses; however, HPV 16 and 18 have been identified as the two types of HPV associated with the highest risk of developing cervical cancer.

Fortunately, the risk of death of cervical cancer has been dramatically decreased with screening using the Pap test. Women who are sexually active are urged to undergo screening with the Pap test, which collects a small sample of cells from the cervix.

If precancerous changes of cervical cells are noted, they are referred to as cervical intraepithelial neoplasia (CIN). CIN is stratified based on the risk of turning into cancer, with CIN1 being the least severe, and CIN3 being the most likely to turn into cancer if not treated. Often, patients with less aggressive CIN are just followed with repeated Pap tests annually and never progress to more aggressive CIN. Researchers have been comparing accuracy in screening methods to optimize the rate and category of CIN among women who are sexually active.

Researchers from the United States recently evaluated long-term results data from the ATHENA trial, the largest prospective US registration trial for HPV testing. This trial included over 40,000 women who were 25 years of age or older. All women underwent high-risk HPV (hrHPV) testing and liquid-based cytology (LBC) testing at the beginning of the trial and were followed for at least 3 years.

Women with HPV 16 or HPV18 had the highest incidence of developing CIN3
Women who had no abnormalities found on their hrHPV tests had less than half the risk of developing CIN3 than those who had no abnormalities found on their LBC test.
One in four women who had HPV16 developed CIN3 within 3 years
The researchers stated that “These results indicate that hrHPV testing with genotyping is superior to LBC for cervical cancer screening.” In addition, they stated that adding LBC “provides little benefit over hrHPV alone.”

Reference: Wright T, Castle P, Behrens C, Huh W. Risk of ≥ CIN3 after 3 years of follow-up of 42,209 screened women: End of study results from ATHENA. Late-breaking abstract #1. 2013 annual meeting of the Society of Gynecology Oncology.