Test to better predict whether women with HPV are at risk of cervical cancer

A new test will improve the ability to predict whether women with human papillomavirus (HPV) are at risk of developing cervical cancer, scientists say.

Ninety-nine per cent of cervical cancers are caused by HPV, and more than 200 HPVs associated with varying degrees of cancer risk complicate diagnosis and treatment.

But researchers have come up with a new approach that not only detects the type of HPV infection, but also indicates precancerous marker.

The study published in The Journal of Molecular Diagnostics says the test may improve the ability to diagnose the riskiest forms of HPV infection, provide rapid results at low cost, and help avoid unnecessary diagnostic procedures.

Scientists have developed HPV RNA-Seq, a diagnostics procedure for the detection of high-risk HPV infection, and the identification of patients with lesions that are a precancerous stage of the cervix.

It combines HPV typing and cell phenotyping.

The test was used to analyse samples from 55 patients, 28 with low-grade squamous intraepithelial lesions (LSIL) and 27 patients with precancerous high-grade squamous intraepithelial lesions (HSIL).

It was able to detect and determine the type of HPV infection among a panel of 16 high-risk HPVs.

It detected two more HPV-positive patients than the DNA test and also identified more patients with multiple HPV infections, researchers say.

The test was found to have a sensitivity – ability to detect the presence of an HPV – of 97.3%, and negative predictive value (NPV) – likelihood of not having HPV – of 93.8%.

Professor Marc Eloit of the Pathogen Discovery Laboratory, Biology of Infection Unit, Institute Pasteur, Paris, said: “Effective cervical cancer screening requires high sensitivity and NPV for high-risk HPV infection, since women with a negative HPV test are usually tested again only after several years.”

Cytology is used as a rapid method to triage patients with HPV, while the more invasive histology is considered the gold standard for cervical cancer diagnosis.

To determine if the new test has a place in cervical cancer triage, the investigators also compared cytology to HPV RNA-Seq and found markers of high-grade cytology, with encouraging diagnostic performances of HPV-RNA-Seq as a triage test.

“This observation constitutes a solid argument in favour of a potential added medical value of HPV RNA-Seq compared with cytology,” added Prof Eloit.

Prof Eloit suggests the use of HPV RNA-Seq in certain patients can help eliminate unnecessary procedures.

The test may also be applicable for other HPV-associated cancers such as anal cancer and head and neck cancer.

It emerged over the weekend that Boris Johnson’s estranged wife Marina Wheeler is recovering from cervical cancer – undergoing two operations after routine screenings revealed abnormal cells.

Ms Wheeler, who separated from Mr Johnson last year, has now urged other women to make time for a test.

She told the Sunday Times: “If you are basically healthy, active and energetic, it is easy to think you are immortal, but none of us is.”

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