Some studies indicate that nearly all cervical cancers are high-risk human papillomavirus (hrHPV)-related.1 Recent studies suggested hrHPV testing had a very high sensitivity2; therefore, the American Society for Colposcopy and Cervical Pathology recommended Pap cytology and hrHPV co-testing as the preferred screening method in women 30 or older.3,4 However, a wide range of negative detection rates of hrHPV have been reported in cervical cancers by different HPV testing methods, including the HC2 test (Qiagen), the most widely used HPV assay in the United States.
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What is cervical dysplasia?
Cervical dysplasia is a condition in which healthy cells on the cervix undergo some abnormal changes. The cervix is the lower part of the uterus that leads into the vagina. It’s the cervix that dilates during childbirth to allow the fetus to pass through.
In cervical dysplasia, the abnormal cells aren’t cancerous, but can develop into cancer if not caught early and treated.
Despite a growing awareness of HPV-negative cervical cancers, which will be missed under the new screening program, experts insist moving away from Pap smears will save more lives overall.
Due to roll out across Australia in May 2017, the revised screening program will see women tested every five years instead of every two, and assessed for HPV in the first instance rather than by cytology Pap smear.
Each year, about 42,700 new cases of cancer are found in parts of the body where human papillomavirus (HPV) is often found. HPV causes about 33,700 of these cancers.
Human papillomavirus infections play the predominant carcinogenic role for cancers of the lower female genital tract, and in particular cervical cancer. Molecular pathways of how these viruses contribute to neoplastic transformation of epithelial cells have to a large extent been clarified and thus will be considered in more detail in the following paragraphs. Published reports on the concept that infectious agents may be involved in the pathogenesis of cancers of the female lower genital tract dates back to the middle of the nineteenth century.
HPV DNA-based screening is more effective than a Pap test in preventing cervical cancer, but the test is less specific. New HPV tests have been proposed for primary screening. The HPV mRNA test showed a similar or slightly lower sensitivity than the HPV DNA tests but with a higher specificity. We report the results of an organised HPV mRNA-based screening pilot program in Venice, Italy.
To assess the performance of a 5-type human papillomavirus (HPV) messenger RNA (mRNA) test in primary screening within the framework of the Norwegian population-based screening programme.
Nationwide register-based cohort study.
In 2003-2004, general practitioners and gynaecologists recruited 18 852 women for participation in a primary screening study with a 5-type HPV mRNA test.