What are the long-term benefits and harms of human papillomavirus (HPV) testing?
According to a study of over 450,000 women, human papillomavirus (HPV) testing results in more cervical intraepithelial neoplasia’s/CIN3+ lesions being detected at a faster rate. The study published recently by JAMA Oncology, was conducted by researchers from Queen Mary University of London (London, UK) and the University of New Mexico Comprehensive Cancer Center (New Mexico, USA).
In this observational study, researchers wanted to discover the long-term benefits and harms of HPV testing among women with cytology showing atypical squamous cells of an undetermined significance. The team demonstrated that utilizing HPV testing after abnormal cytology leads to an earlier and more complete detection of high-grade CIN lesions, however, this comes at the expense of more biopsies and loop electrosurgical excision procedures.
Cosette Wheeler from the University of New Mexico Comprehensive Cancer Center stated: “The benefits of HPV testing outweigh the harms observed but it’s important to understand and quantify the harms as well.”
In the individuals tested, most high-grade disease occurred in the 43.1% of women who were HPV positive. Jack Cuzick from Queen Mary University of London commented: “This study shows that knowing a woman’s HPV status can help determine her likelihood of needing additional procedures, and prioritize immediate treatment and medical resources to the women who need them most.”
Although these data provide essential information for cervical screening guidelines and public health policy, the authors caution that as this was an observational study, the use of HPV testing was not randomized meaning that there is a possibility that differences in health care facilities or other socioeconomic factors may of not been measured.
Sources: Cuzick J; Myers O; Lee JH et al. Outcomes in women with cytology showing atypical squamous cells of undetermined significance with vs without Human Papillomavirus testing JAMA Oncology doi:10.1001/jamaoncol.2017.1040 (2017); Eureka Alert press release
