Does HPV DNA screening help detect cervical cancer?

January 01, 0001

Does HPV DNA screening help detect cervical cancer?

Cervical cancer screening guidelines have recently been in the news. This group of Finnish researcher sought to assess the use of primary human papillomavirus (HPV) DNA screening with cytology triage compared with conventional cytology on cervical cancer and severe pre-cancerous lesions. They performed a randomized controlled trial within a population based cervical cancer screening program in Finland. Women aged 30-60 were recruited (n=58,076). HPV DNA test with cytology triage was compared with conventional cytological screening using the rates of cervical cancer, cervical intraepithelial neoplasia (CIN) grade III, and adenocarcinoma in situ.

The researchers found: "In the HPV and conventional arms there were 95,600 and 95,700 woman years of follow-up and 76 and 53 cases of CIN III+, respectively (of which six and eight were cervical cancers). The relative rate of CIN III+ in the HPV arm versus the conventional arm was 1.44 among all women invited for screening and 1.77 among those who attended. Among women with a normal or negative test result, the relative rate of subsequent CIN III+ was 0.28. The rate of cervical cancer between arms was 0.75 (among women invited for screening and 1.98 among those who attended."

The researchers concluded: "When incorporated into a well established organised screening programme, primary HPV screening with cytology triage was more sensitive than conventional cytology in detecting CIN III+ lesions. The number of cases of cervical cancer was small, but considering the high probability of progression of CIN III the findings are of importance regarding cancer prevention."

This large study suggest there may be a role for the use of HPV DNA screening as the primary cervical screening tool.

For the full abstract, click here.

BMJ 340:c1804, 27 April 2010 © 2010 Anttila et al.
Rate of cervical cancer, severe intraepithelial neoplasia, and adenocarcinoma in situ in primary HPV DNA screening with cytology triage: randomised study within organised screening programme. Ahti Anttila, Laura Kotaniemi-Talonen, Maarit Leinonen, et al. Correspondence to A Anttila: [email protected]

Category: X. Female Genital System, Breast. Keywords: cervical cancer, HPV, HPV DNA screening, screening test, cytology, randomized controlled trial., journal watch.
Synopsis edited by Dr Paul Schaefer, Toledo, Ohio. Posted on Global Family Doctor 18 May 2010

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