HPV Testing Is Cheaper and More Effective for Women After Pre-Cervical Cancer Treatment
HPV testing, as opposed to more frequent pap smears, is better at identifying women at high risk for recurring cervical disease
--by Heather Kathryn Ross
Each year, thousands of women are treated for cervical intraepithelial neoplasia, or CIN—lesions on the cervix that can develop into cervical cancer. After treatment for CIN, the usual course is to have follow-up pap smears (cytology tests) at least once per year to ensure that the lesions have not returned.
However, UK researchers have found that follow-up testing for HPV—a virus that can cause genital warts and cervical cancer—after treatment for CIN is not only more effective for identifying women at high risk for recurring lesions, but it also costs less than administering more frequent pap smears.
“We found that the early use of human papillomavirus (HPV) testing after treatment averts more cases of Stage 3 CIN, and is also cost saving compared with cytology only follow-up because it seems to be more effective at the early identification of women who are at risk of recurrent disease,” wrote the authors from the London School of Hygiene and Tropical Medicine.
The Expert Take
The study authors also say that screening for HPV soon after CIN treatment prevents women from undergoing unnecessary (and sometimes painful) colposcopies. A colposcopy involves taking a very close look at the surface of the cervix and performing a biopsy to remove a small amount of cervical tissue for testing.
Many colposcopies result in re-treatment, so avoiding excess colposcopy tests not only eases the financial and emotional burden on women, it also saves money for the healthcare system as a whole.
Source and Method
Researchers developed a mathematical model to calculate the cost and effectiveness of follow-up treatment after CIN in a group of women, most of whom were under the age of 35 and had had either Stage 2 or Stage 3 CIN.
According to their calculations, cytology-only follow-ups detected 29 recurring cases of Stage 3 CIN per 1000 women over 10 years. The HPV “test for cure” approach averted approximately eight more cases during the same time period. The cytology only follow-up cost an estimated $577,700 per 1,000 women, while the HPV “test of cure” follow-up saved just over $15,000 per 1000 women treated.
The study was released today online in the British Medical Journal.
The bottom line is clear, and the study authors say that, though they are still gathering long-term follow-up data, their findings should be used to develop cheaper and more effective screening strategies for at-risk women.
“The findings of this analysis suggest that a single round of cytology and human papillomavirus testing six months after treatment [for CIN] effectively identifies women at future risk of serious recurrent disease,” the authors wrote.
A study published in March in the British Medical Journal concluded that detecting a woman’s cervical cancer through regular screenings (in this case, in the form of pap smears) results in a better chance that her cancer will be cured.