New advanced DNA test could make pap smears obsolete

Lufkin, TX

Annual pap smears could soon move to medical history books. Dr. Kay Carter said the new advanced dna test could save women's lives. "It can tell whether the DNA is high risk or low risk DNA for the HPV virus," said Dr. Carter.

She said the DNA test will make gynecologists' jobs easier. That is because it is a one step screening process

"If a woman has a high risk HPV virus then we will automatically go directly to biopsies and test that gives us more accurate information than the pap smear screen does," said Dr. Carter.

Dr. Carter believes most women get an annual pap smear out of routine and don't really understand its purpose. "I don't think that women classically understand the pap smear and why we have to do it," said Dr. Carter. She said the new DNA test makes it easier to understand that there is a virus that causes cervical cancer and women need to be checked for that virus.

Women over 30 could drop the annual pap smear and instead get a DNA test every three, five or ten years. The women we talked to said the pap smear does not bother them. "It's better to be safe than sorry, waiting three years is a long time, once a year is pretty accurate," said Becca Tatum, patient.

"You're going to have to come in for a yearly exam anyways, a breast exam, a pelvic exam so you mine as well get the pap smear done while you are," said Wendy Burger, patient.

Dr. Carter said over time, the DNA test will also cut yearly medical expenses.

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New detection tool pinpoints virus behind cervical cancer

Nahariya, Israel

The Western Galilee Hospital in Nahariya is the first hospital in Israel to implement a new method of detecting the human papilloma virus (HPV), which causes cervical cancer.

Dr. Yaakov Borenstein, who runs the hospital's women's health unit, described the HPV test Tuesday at a gynecologists' conference at the Dan Carmel Hotel in Haifa.

The test, which characterizes the virus' genetic material - the most precise way to test for the virus - is 97 percent accurate, compared to just 50 percent for the more familiar Pap smears. The method also allows far earlier detection, because it diagnoses the presence of the virus instead of looking for pre-cancerous changes, as do Pap smears.
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Cervical cancer is the second most common form of cancer - after breast cancer - affecting women around the world, said Borenstein. HPV has been shown over recent years to be closely related to cervical cancer and pre-cancerous states.

The Israel Society of Obstetrics and Gynecology recommends that women between the ages of 25 and 60 be tested every three years.

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Earlier detection of cervical cancer through HPV DNA testing could permit longer screening interval

10.5.07

They conclude: A full cost-effectiveness analysis will help to determine whether primary HPV testing alone is the preferred strategy for primary cervical screening.

By Lancet, [RxPG] Using human papillomavirus (HPV) DNA testing detects the lesions which lead to cervical cancer earlier than do conventional cytological techniques; this earlier detection could allow the screening interval to be extended. These are the conclusions of authors of an Article published early Online and in an upcoming edition of The Lancet.

Professor Chris Meijer, VU University Medical Centre, Amsterdam, Holland, and colleagues studied 17155 women aged 29 to 56 years participating in the regular cervical screening programme in the Netherlands. Of these, 8575 were assigned to HPV DNA testing to detect the high-risk types of human papillomavirus which can cause cervical cancer, while 8580 had conventional cytological testing. Five years later both cytological and DNA testing was done in both groups.

While it was already known that HPV DNA testing detects more CIN lesions, it was not clear until now whether or not these lesions were indeed relevant (non-regressive) cancer precursors. The researchers found that more CIN3+ lesions (cervical cancer and its most serious precursor lesions) were detected in the women given HPV DNA testing (68/8575 positive results) compared with the conventional cytological testing group (40/8580). Five years later, fewer women were detected with CIN3+ lesions in the HPV DNA group (24/8413) compared with the cytological testing group (56/8456). Thus, while of the number of patients with CIN3+ lesions detected over the two rounds did not differ between the groups, these lesions were detected earlier in the HPV DNA testing group.

The authors say: Our results show that implementation of HPV DNA testing in cervical screening leads to earlier detection of clinically relevant cervical lesions. On the basis of this data, we suggest that the current screening interval of five years could be extended by at least one year. The extension will be advantageous to women because of a reduction in the lifetime number of screening tests and referrals.

They conclude: A full cost-effectiveness analysis will help to determine whether primary HPV testing alone is the preferred strategy for primary cervical screening.

In an accompanying Comment, Drs Guglielmo Ronco and Nereo Segnan. Unit of Cancer Epidemiology, CPO Piemonte, Torino, Italy say: The much lower risk of CIN3+ lesions seen in women classified as screen-negative in the experimental group than in the control group shows that extended screening intervals will be safe with HPV-DNA testing. They add that such longer intervals will not only reduce the cost of screening but also the burden for women, as well as improving participation, which is crucial since non-participation [in screening] is still the most important reason for later development of cervical cancer in most developed countries.

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