Reviews and Perspectives with Hobart Lee: HPV-Based Cervical Cancer Screening
Hobart Lee, MD, and Heidi James, MD
Hoby and Heidi reveal the pap test-less future! Well, actually, they review 2 papers on HPV-based cervical cancer screening: one on practitioner-done swabs, another on patient-done swabs.
- Cervical cancer screening is cytology based in most countries, with samples being obtained via pap smear.
- Cervical cancer is caused (largely) by oncogenic strains of human papillomavirus (HPV), primarily 16 and 18.
- Detecting the presence of these strains would indicate higher risk of cervical cancer.
- A study by Rebolj et al. showed that practitioner-obtained HPV swabs resulted in
- greater detection of lesions cervical intraepithelial neoplasia (CIN) 3 and greater than liquid cytology, and
- fewer >CIN 3 lesions on follow-up.
- A study by Polman et al. found that self-swabs done by patients were effective at detecting oncogenic HPV strains.
- Hoby and Heidi discuss potential implications of these results, including
- cost savings and
- greater uptake of cervical cancer screening if patients can self-swab instead of having pap smears.
PEARL: Self-swabs for oncogenic HPV strains are the future of cervical cancer screening
References
Primary cervical screening with high risk human papillomavirus testing: observational study
Rebolj M, Rimmer J, Denton K, et al. BMJ. 2019;364:I240. doi: 10.1136/bmj.l240.
HPV-based cervical screening: rationale, expectations and future perspectives of the new Dutch screening programme
Polman NJ, Snijders PJF, Kenter GG, et al. Prev Med. 2019;119:108-117. doi: 10.1016/j.ypmed.2018.12.021.
