HPV testing improves cervical cancer screening

By Megan Rauscher

NEW YORK (Reuters Health) – Testing for human
papillomavirus (HPV) may be a useful first step for cervical
cancer screening in women younger than 35 years, preliminary
findings indicate.

Testing for HPV is better than standard cell testing at
picking up pre-cancerous changes, but it is also more likely to
yield false results. This is particularly true among young
women, where there is a higher rate of infection, Dr. Guglielmo
Ronco explained in comments to Reuters Health.

Using the strategy of HPV testing first, followed by
cervical cell examination if needed, “we showed that it is
possible to have a relevant increase” in pre-cancer detection
without increasing the false results, even among young women,
said Ronco, from the Center for Cancer Prevention in Turin,
Italy.

In the new study, Ronco and the New Technologies for
Cervical Cancer Screening Working Group assigned 5,808 young
women to screening with or without HPV testing.

In the group that did receive HPV testing, cell testing was
performed and, if pre-cancerous changes were seen, the women
underwent colposcopy, an examination of the cervix with a
special instrument, was performed. The procedure in the group
that received HPV testing was similar, except cell testing was
only performed if the HPV test was positive.

As noted, the HPV test/cell test approach was better than
the conventional approach at detecting pre-cancerous changes.
Moreover, unlike HPV testing alone, the HPV test/cell test
approach did not increase the number of false results.

The follow-up of this study and other similar trials should
provide information to help guide “the decision to switch to
HPV testing as a routine method for cervical screening,” Ronco
said.

SOURCE: The Lancet Oncology, July 2006.