HPV DNA testing for all women aged 29 years and above

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Implementation of HPV DNA testing in cervical screening leads to earlier detection of clinically relevant CIN grade 2 or worse, which when adequately treated, improves protection against CIN grade 3 or worse and cervical cancer. Early detection of high-grade cervical legions caused by HPV16 was a major component of this benefit.

Testing for the presence of DNA from the human papillomavirus (HPV) alongside conventional screening is the best cervical cancer screening option for all women aged 30 years or older, according to scientists from the Netherlands.

They found that HPV testing combined with liquid-based cytology (commonly known as the smear test) is better at detecting the cell changes that lead to cervical cancer earlier and helps prevent more cervical cancer than the smear test alone.

The work, published in the Lancet Oncology, confirms several other studies that have already shown that HPV testing is more sensitive than the smear test at detecting precancerous cell changes.

The study involved 45,000 woman in the Netherlands who attended routine cervical screening.

The study showed that women who were given HPV tests had a lower chance of subsequently developing more serious changes in the cells of their cervix (known as ‘grade 3 cervical intraepithelial neoplasia’, or CIN3), and cervical cancer, than women who were offered the smear test only during the first round of screening.

The results showed that the combination of smear tests and DNA tests spotted more cases of intermediate (grade 2) changes or worse than smear tests alone.

And follow-on tests conducted five years later found fewer cases of more serious CIN grade 3 changes and cervical cancer in women from the HPV-tested group than those who’d only had the smear test.

The experts also found that HPV testing in women aged 33 and younger had a lower rate of false positive results, which can lead to unnecessary and uncomfortable treatments

Study author Professor Jack Cuzick, a Cancer Research UK epidemiologist based at Queen Mary, University of London, said the study added to the “overwhelming evidence” that including HPV testing in cervical screening programmes would be beneficial.

Researchers conclude that “Our results lend support to the use of HPV DNA testing for all women aged 29 years and older”.

Source: Lancet Oncology, UK

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