Irish Medical News – 25 January 2010
Human papillomavirus (HPV) DNA testing prevents more invasive cervical cancer compared to cytology screening alone, according to new research, published online first in The Lancet Oncology.
According to the authors, HPV DNA tests detect persistent high-grade lesions in women at an earlier time. As such, HPV testing should become the primary screening tool for women aged 35 years or older at longer screening intervals, with cytology reserved for triage of women who test positive for HPV, conclude the researchers, from the Centre for Cancer Prevention in Turin, Italy.
Dr Guglielmo Ronco and his team studied Italian data on 95,000 women, which showed those tested for HPV developed fewer cancers than those who only had smears.
Dr Ronco said: “Our data support the use of stand-alone HPV testing as the primary screening test. Picking up the cancers earlier would save lives.”
He added, however, that this strategy was unsuitable for women younger than 35, since in this age group HPV testing would risk over-treatment because it detects problems that would “right themselves spontaneously”.
Meanwhile, the Irish Cancer Society’s annual Charles Cully memorial lecture took place last week with a lecture from Prof Ian Frazer, the Scottish-born specialist who co-created the HPV vaccine in the 1990s in Australia.
Prof Frazer highlighted the importance of effective public awareness campaigns to combat misinformation circulating about the vaccine and how it works, and to maximize vaccine uptake.
Prof Frazer said that among women under 28 in Australia, there has been “a sharp decline” in cases of genital warts since vaccination with the quadrivalent vaccine Gardasil began.
He said clinical trials are under way to find a vaccine that will prevent cervical cancer in women already infected with HPV.
Prof Frazer also welcomed the recent decision by the Government to introduce a HPV vaccination programme for young girls in Ireland.
Speaking at the memorial lecture, Health Minister Mary Harney said: “I suppose we are late with the (HPV vaccination programme) in comparison to other countries.”
Dr Caitriona Henchion, medical director of the Irish Family Planning Association (IFPA), said the combination of population-based screening and school-based vaccination programme has the potential to “eliminate cervical cancer in Ireland in a generation”.
“This announcement of the vaccination programme was particularly timely in advance of European Cervical Cancer Prevention Week, which will take place from January 24-30, 2010,” she added.