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    Is HPV testing ready for ‘prime’ time in cervical cancer detection?

     

    No. More data are needed before the HPV test can stand alone

     

     

    Dr. Kamat is the Director of Gynecologic Oncology in the Department of Obstetrics and Gynecology at the Methodist Hospital, Houston, Texas.

    She reports receiving service fees from Myriad Genetics.

     

    The United States Food and Drug Administration (FDA) recently approved a DNA-based human papillomavirus (HPV) test as a primary screening option for cervical cancer in women 25 years and older. The cobas HPV test provides high-risk pooled HPV DNA results and individual detection of HPV 16 and HPV 18, both responsible for about 70% of invasive cervical cancer. While the cobas test is currently recommended for use alongside the traditional Pap smear, the FDA’s new approval permits the HPV test to be used on its own as a screening tool.

    Current guidelines based on recommendations by the American Cancer Society and the US Preventive Services Task Force recommend that doctors screen women ages 21 to 65 every 3 years using a Pap smear.1 Alternatively, the groups recommend a screening procedure called “cotesting,” which combines the Pap smear and HPV testing for screening of women ages 30 to 65 for cervical cancer every 5 years. With the newly approved algorithm, women would be screened using the cobas HPV test. Those who test positive for HPV 16 and HPV 18 would be triaged directly to colposcopy and directed biopsies and only those who were positive for the other 14 HPV types would undergo cytology. Patients who are HPV-negative would undergo routine screening with further DNA testing, thus eliminating the Pap smear in the majority of cases.

     

    Sarah Feldman, MD, MPH
    Dr. Feldman is Associate Professor of Obstetrics, Gynecology and Reproductive Biology at Harvard Medical School, Director of Ambulatory ...
    Aparna Kamat, MD
    Dr. Kamat is the Director of Gynecologic Oncology in the Department of Obstetrics and Gynecology at the Methodist Hospital, Houston, Texas.

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