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Navigating Precision Prevention: Evolution of Cervical Cancer Screening Strategies

NextEdge Admin

06 Feb 2024

2 min 54 sec

Liquid-based cytology (LBC) plays a pivotal role in cervical cancer screening, involving the collection of cervical cells in a liquid medium for analysis, serving as a crucial initial step in precision prevention. The World Health Organization (WHO) recommends Human Papillomavirus (HPV) DNA testing as the primary screening method to prevent cervical cancer. Laboratories conducting LBC should integrate results from the original HPV test and repeat LBC in their cervical screening reports.

HPV screening, particularly molecular HPV testing, has become the forefront of cervical cancer screening due to its association with carcinogenesis. The first FDA-approved high-risk human papillomavirus (HR HPV) device for routine cervical cancer screening was the Hybrid Capture 2 (HC2) DNA test in 2003. Among the 193 available HPV tests, HC2 has seen widespread adoption with sensitivities ranging from 84.9% to 100%. More recent tests like the Cervista HPV HR test and the Cobas 4800 HPV test, approved in 2009 and 2011 respectively, exhibit improved accuracy and enhanced specificity. However, challenges persist, particularly with false negatives stemming from viral integration into the host genome. The latest HR HPV device gaining FDA premarket approval was the BD Onclarity HPV Assay in 2018.

Alternative approaches involve detecting HPV E6/E7 oncogene mRNA, establishing a direct link to disease progression and potentially reducing unnecessary colposcopy referrals. Future prospects lie in next-generation sequencing (NGS) technologies, which address current limitations by determining coinfections and integration sites, offering more accurate predictions of disease progression. Despite the promise of NGS-based HPV testing, challenges include interpreting results cautiously due to a high false-positive rate, addressing cost concerns, and developing automated, standardized, and user-friendly interpretation tools for routine diagnostics.

The American Cancer Society (ACS) emphasizes key preventative measures, including HPV vaccination for eligible individuals and regular testing following ACS guidelines.