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8th November 2021  Content supplied by: Jiangsu Bioperfectus Technologies Co., Ltd.

Protecting Women’s Health – HPV Testing Assists in Eliminating Cervical Cancer


Although cervical cancer is proven to be a preventable and treatable disease, in the year 2020 more than 500,000 women worldwide were suffering from it, and among which approximately 342,000 died from it. A fast and accurate screening plan is critical for the prevention and early detection and is crucial for the elimination of cervical cancer.

On July 6, 2021, WHO released the latest guideline for the screening and treatment of cervical precancerous lesions to optimize diagnostic tools and screening options, promote cervical cancer prevention, and save more lives. The new guideline recommends HPV DNA testing as the primary method for cervical cancer screening.

The update of the guideline includes 23 recommendations and 7 good practice statements for screening. The new guideline recommends HPV DNA testing as the preferred method, rather than the widely used visual inspection with acetic acid (VIA) or cytology (also often referred to as "Pap smear").

The guideline emphasizes that HPV DNA testing can detect high-risk types of HPV (rhHPV), which lead to almost all cases of cervical cancers. Unlike methods that rely on visual inspection that operates manually, HPV DNA testing is an objective diagnosis with an auto-analyzer that has comparably higher accuracy especially among people with early and mid-stage cervical squamous cell lesions.

Although for doctors, the process of obtaining cervical samples in HPV DNA testing and cytology is similar, HPV DNA testing is easier to perform. In addition, HPV DNA testing is more cost-effective under most scenarios according to WHO’s modeling estimates. For areas where VIA testing is adopted, WHO recommends a rapid change replacing VIA testing with HPV DNA testing as the main screening method for cervical cancer.

Women with weakened immune function are more susceptible to cervical disease. Among them, women infected with HIV have a six-fold higher risk of cervical cancer. They are more likely to be continually infected with HPV and are more rapidly developed into cervical precancerous lesions.

Therefore, the new guideline provides a number of recommendations specifically for women infected with HIV. Some of the recommendations are similar to those of ordinary women. The main difference is that the management strategy of “screening, triage, and treatment” is adopted, which is more cost-effective among HIV-infected women.

Data showing where countries around the world currently stand in relation to their burden of cervical cancer and coverage for screening and treatment are due to be published by the end of 2021. These country profiles can help ministries of health identify where their programmes need strengthening and measure progress towards the 2030 targets.

For a cervical cancer prevention and control programme to have an impact, strengthening patient retention and ensuring rapid treatment of women who screen positive for HPV or cervical pre-cancer is a fundamental priority.

Recommendations and good practice statements (for general population of women):

WHO suggests using either of the following strategies for cervical cancer prevention among the general population of women:

  • HPV DNA detection in a screen-and-treat approach starting at the age of 30 years with regular screening every 5 to 10 years.
  • HPV DNA detection in a screen, triage and treat approach starting at the age of 30 years with regular screening every 5 to 10 years.

Recommendations and good practice statements (women living with HIV):

WHO suggests using the following strategy for cervical cancer prevention among women living with HIV:

  • HPV DNA detection in a screen, triage and treat approach starting at the age of 25 years with regular screening every 3 to 5 years.

Screen-and-treat approaches:
1. Visual inspection with acetic acid (VIA) as the primary screening test, followed by treatment

2. HPV DNA (self- or clinician-collected) as the primary screening test, followed by treatment

Screen, triage and treat approaches:
3. Cytology as the primary screening test, followed by colposcopy triage, followed by treatment

4. HPV DNA as the primary screening test, followed by HPV16/18 triage (when already part of the HPV test), followed by treatment, and using VIA triage for those who screen negative for HPV16/18

5. HPV DNA as the primary screening test, followed by VIA triage, followed by treatment

6. High-risk HPV DNA as the primary screening test, followed by colposcopy triage, followed by treatment

7. HPV DNA as the primary screening test, followed by cytology triage, followed by colposcopy and treatment

Key to curing cervical cancer, regular HPV screening will greatly reduce the chance of the infection. Bioperfectus Human Papillomavirus Real-Time PCR Kit is able to detect 96 samples in 100 minutes with the ability to respectively report HPV-16 and HPV-18 as primary evidence for cervical cancer screening. Bioperfectus Human Papillomavirus Genotyping Real-Time PCR Kit is designed to precisely detect 21 genotypes of HPV for further triage and treatment with reliable clinical performance.

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References:
1. WHO guideline for screening and treatment of cervical pre-cancer lesions for cervical cancer prevention, second edition. .
2. New recommendations for screening and treatment to prevent cervical cancer, WHO  
3. Benevolo, M. et al. 2011. Sensitivity, Specificity, and Clinical Value of Human Papillomavirus (HPV) E6/E7 mRNA Assay as a Triage Test for Cervical Cytology and HPV DNA Test.  Journal of Clinical Microbiology, p. 2643–2650 Vol. 49, No. 7


    

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Date Published: 8th November 2021

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