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New HPV self-testing approach could enhance cervical cancer screening

New HPV self-testing approach could enhance cervical cancer screening

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Analysis of human papillomavirus (HPV) self-tests can be used to divide HPV-positive women into three risk groups, according to a new study from Karolinska Institutet and Queen Mary University of London published in the journal PLOS Medicine. It is said that it can be done. This method could be important for enhancing cervical cancer screening.

The study looked at British women who were recommended to self-test for HPV in a clinical trial because their cervical cancer screening deadline had passed.

“Self-testing for HPV has become an important component of cervical screening, reaching women who might not otherwise participate,” said the Department of Medical Epidemiology and Biostatistics and Department of Clinical Sciences. said Jiayao Lei, assistant professor in the Department of Intervention and Technology. I am the lead author of this study.

The study, carried out at a primary care center in the UK, included 855 women with a positive HPV self-test, meaning they had an HPV infection, and clinician samples were also subsequently taken. Seventy-one (8.3%) of these women were found to have severe cervical precancer or cancer.

Further investigation into high-risk groups

Researchers took a closer look at HPV test results in self-samples and used a new method to assess the risk of severe cell changes. Risk stratification is based on HPV viral variants and the amount of virus present during self-testing (measured as cycle threshold, Ct value). This was used to classify women into three risk groups: high-risk, medium-risk, and low-risk. Women with HPV type 16 and low Ct values ​​(<30) had the highest risk of severe cervical precancer or cervical cancer.

Approximately 40% of women in our high-risk group had been diagnosed with severe cervical precancers or cancers that required treatment. Therefore, our recommendation going forward is to refer this group directly for further investigation by colposcopy. ”


Jiayao Lei, Assistant Professor, Department of Medical Epidemiology and Biostatistics and Department of Clinical Sciences, Interventions and Technology, Karolinska Institutet

More than half of those who tested positive were in the low-risk group, with a 4% chance of being diagnosed with severe precancerous or cervical cancer within 12 months.

“While we think it is safe for low-risk groups to be retested after 12 months, intermediate-risk groups should be encouraged to be tested by a clinician,” said study lead author Dr. Peter Sacieni, a professor at the University of Mary. .

Benefits of risk stratification

One of the main advantages of the new method is that risk assessment can be performed immediately after HPV self-testing and does not require further laboratory analysis.

“This could be particularly useful for cervical cancer screening in low- and middle-income countries with limited resources,” says Peter Sasieni.

Next steps in research

With support from the Swedish Cancer Society, we are conducting a large population study based on self-testing based on an alternative assay to test the feasibility of incorporating such risk stratification into routine screening programs. It is planned to be held in Sweden. We also want to investigate the predictive value of the current test results in combination with other markers for HPV-positive women.

This research was funded by Cancer Alliances, Cancer Research UK and the Swedish Research Council.

sauce:

Reference magazines:

Ray, J. others. (2024). Human papillomavirus genotype and cycle thresholds from self-samples and risk of high-grade cervical lesions: Post-hoc analysis of a modified step wedge implementation feasibility study. PLOS medicine. doi.org/10.1371/journal.pmed.1004494.

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