Women Aging Beyond 30– Highly Encouraged To Undergo HPV DNA Testing

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Cervical cancer is one of the common malignancies in women, which has devastating effects to one’s life. While prevention is important, early detection remains crucial. A research found in The Lancet Oncology gave light to HPV DNA testing as the better method in cervical cancer prevention and early detection for females over 30, against cytology solely.  After their report on the POBASCAM Trial, the researchers have now relevant data supporting routine HPV testing as a national screening program.

Hormuzd Katki and Nicolas Wentzensen included in their comments that POBASCAM made the results from cohort studies, routine clinical practice and clinical trials more solid. They adhered reliable proof has been found on the advantages of HPV testing’s inclusion in national screening programs. Moreover, in the identification of precancerous high-grade cervical lesions, it was already evident in the experts’ viewpoint that HPV testing is better than cytology. Nonetheless, this research paved the way in determining which detection method was best through 5 years interval in screening.

The POBASCAM trial included 45,000 women, 29-56 years old, who underwent routine cervical screening in the Netherlands. They were chosen randomly to undergo HPV DNA testing plus cytology or cytology only. This study was performed by Chris Meijer and team from the VU University Medical Center, Amsterdam. The researchers’ aim was to establish a link between HPV testing and less high-grade lesion and malignancy during the second round of screening. So, after 5 years, the participants received both HPV and cytology for the second round.

The findings revealed that the first screening detected more cancer markers with HPV testing, rather than cytology alone. In the second screening, less incidences of CIN grade3 or worse lesions and cervical cancer were observed in women belonging to HPV testing group, compared to those who only received cytology. According to the researchers, earlier detection of possible high-grade lesions (caused by HPV16) was made with HPV DNA testing as cervical screening method. This led to ample medical intervention and greater protection against worse lesions and malignancy. Moreover, the authors believe that HPV testing can decrease cancer-related deaths.

The authors further elaborated that HPV testing does not seem to be related to regressive CIN2+ lesions over-diagnosing among younger females. Similar accumulated CIN2+ and CIN3+ detection was observed in females 29-33 years old and those more than 33. Furthermore, the authors expressed their support to the HPV DNA testing cervical screening program for women 30 and beyond. In a commentary, authors emphasized that this 5-year interval screening POBASCAM trials are safe, but its effects on other populations with diverse cancer rates, compliance and management structure are still unknown.




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