• HPV DNA Testing for Cervical Cancer Screening

    Big Image for hpv articleCervical cancer is a disease in which cancer cells grow in the cervix. Fortunately, cervical cancer can be prevented if precancerous cell changes are detected and treated early.
    The human papillomavirus (HPV) is the primary cause of nearly all cases of cervical cancer. HPV can be passed from one person to another through sexual contact. In most cases, the HPV virus is harmless and causes no symptoms. In fact, many young women who become infected with HPV are able to clear the infection through their own immune systems. However, certain high-risk types of HPV can cause cervical lesions. Over time, these may develop into cancer if untreated.
    The Pap smear is used detect cancerous and precancerous cervical lesions. Unfortunately, the Pap smear has been associated with false negative rates in some cases. In a false negative, the test indicates the pap smear is normal when, in fact, there is an abnormality. Women with abnormal results need further testing.
    The HPV test can be used in conjunction with the Pap test. The test determines the presence or absence of HPV and whether or not the HPV type present is the type that is associated with cancer.

    The HPV Test

    The HPV test is collected similar to a Pap smear. A cervical brush or other collection device is inserted into the cervix to collect cells for testing. This sample is then sent to the lab for evaluation.
    A negative result means that high-risk, cancer-causing types of HPV were not detected. Therefore, your risk of developing high-grade cervical disease before your next routine visit is extremely low.
    A positive HPV result may mean an increased risk of developing cervical cancer if the precancerous type is present. In this case, further examination will be needed in order to determine whether your cervix shows pre-cancerous or cancerous changes. If no changes are detected, you will be closely monitored to make sure that any changes are detected as early as possible. If precancerous changes are detected, you should know that several highly effective treatment options are available.

    Questions to Ask Your Doctor

    To find out if HPV testing is right for you, be sure to ask your doctor the following questions on your next doctor visit:
    • Am I a candidate for an HPV test as part of my cervical cancer screening program?
    • Do you provide HPV testing as a follow-up to help clarify inconclusive Pap test results?
    • If I have an inconclusive Pap test result, can you ask the lab to perform an automatic HPV test from the same Pap sample?
    • Will my insurance cover the HPV test?
    • Can I talk to you about questions I have about HPV and cervical cancer?

    RESOURCES

    American Cancer Society http://www.cancer.org

    National Cancer Institute http://www.cancer.gov

    CANADIAN RESOURCES

    Canadian Cancer Society http://www.cancer.ca

    Society of Obstetricians and Gynaecologists of Canada http://www.sogc.org

    References

    American Cancer Society. Cancer Facts & Figures. 2003;19-20.

    Cancer facts: human papillomavirus (HPV) vaccines. National Cancer Institute website. Available at:http://www.cancer.gov/cancertopics/factsheet/prevention/HPV-vaccine . Updated December 29, 2011. Accessed February 26, 2013.

    Centers for Disease Control and Prevention. Sexually Transmitted Diseases Treatment Guidelines, 2010. MMWR. 2010;59(No. RR-12):1-110.

    Cervical cancer screening. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated February 19, 2013. Accessed February 26, 2013.

    Cervical cancer screening guidelines. Cleveland Clinic website. Available at: http://my.clevelandclinic.org/disorders/cervical%5Fcancer/cervical%5Fcancer%5Fguidelines.aspx. Updated March 24, 2010. Accessed February 26, 2013.

    Cuzick J. Human papillomavirus testing for primary cervical cancer screening. JAMA . 2000;283:108-109.

    Human papillomavirus (HPV): signs and symptoms. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/hpv/signs-symptoms.html. Updated February 5, 2013. Accessed February 26, 2013.

    Human papillomavirus (HPV) vaccines. National Cancer Institute website. Available at: http://www.cancer.gov/cancertopics/factsheet/prevention/HPV-vaccine. Updated December 29, 2011. Accessed February 26, 2013.

    Kulasingam SL, Hughes JP, Kiviat NB, et al. Evaluation of human papillomavirus testing in primary screening for cervical abnormalities. JAMA . 2002;288:1749-1757.

    Making sense of your Pap and HPV test results. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/std/hpv/pap/default.htm. Updated July 25, 2012. Accessed February 26, 2013.

    Manos MM, Kinney WK, Hurley LB, et al. Identifying women with cervical neoplasia: using human papillomavirus DNA testing for equivocal Papanicolaou results. JAMA . 199;281:1605-1610.

    Pap and HPV testing. National Cancer Institute website. Available at: http://www.cancer.gov/cancertopics/factsheet/detection/Pap-HPV-testing. Updated May 23, 2012. Accessed February 26, 2013.

    Schiffman M, Herrero R, Hildesheim A, et al. HPV DNA testing in cervical cancer screening: results from women in a high-risk province of Costa Rica. JAMA . 2000;283:87-93.

    Wright TC, Cox JT, Massad LS, et al. 2001 consensus guidelines for the management of women with cervical cytological abnormalities. JAMA . 2002;287:2120-2129.

    Wright TC, Denny L, Kuhn L, et al. HPV DNA testing of self-collected vaginal samples compared with cytologic screening to detect cervical cancer. JAMA. 2000;283:81-86.

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