Featured Research

from universities, journals, and other organizations

Cheaper and more effective test available for women following pre-cervical cancer treatment, study suggests

Date:
November 1, 2012
Source:
BMJ-British Medical Journal
Summary:
Testing women to see if they are cured of HPV (the virus that can cause genital warts and cervical cancer) following treatment for abnormal cells on the surface of the cervix is more effective and cheaper than cytology testing (cervical screening) alone, suggests a new study.

Testing women to see if they are cured of HPV (the virus that can cause genital warts and cervical cancer) following treatment for abnormal cells on the surface of the cervix is more effective and cheaper than cytology testing (cervical screening) alone, suggests a study published on the British Medical Journal website. A second recently published study, finds that the risk of cervical cancer after treatment and cytological follow-up for abnormalities remains about four times higher than in women with normal cytology tests, regardless of age and stage of abnormality.

In England, cervical screening is recommended every three years for women aged 25-49 and every five years for women aged 50-65 years.

Cervical intraepithelial neoplasia or CIN are pre-cancerous lesions on the surface of the cervix that can develop into cervical cancer if left untreated. After treatment for high grade CIN, guidelines in the UK previously recommended annual cytology for at least 10 years. After low grade CIN, cytology is recommended at six, 12 and 24 months, and if all results are negative then women can resume routine screening.

Previous studies are inconsistent about whether or not HPV testing as 'test of cure' is more effective or cost-effective than cytology testing alone. So far, only two published studies have been identified, one concluding that it was potentially a cost-effective strategy and the other that it increased costs and added little or no improvement to life expectancy.

Authors from the London School of Hygiene & Tropical Medicine and Cancer Council, NSW in Australia therefore carried out a study to assess the cost-effectiveness of HPV testing after treatment for CIN. They took data from six sites across England that returned women to routine screening after a single negative HPV test result at six months.

Almost two-thirds (63%) of women were aged 35 or younger and one in 10 had been treated for CIN stage 1. The rest were treated for CIN stages 2 or 3.

Cytology only follow-up after treatment for CIN resulted in 29 reoccurring cases of CIN stage 3 per 1000 women over 10 years. The HPV 'test for cure' averted around eight additional cases over this time. The cytology only follow-up estimated cost is 358,222 per 1,000 women with HPV 'test of cure' costing 348,834, saving approximately 9,388 per 1000 women treated.

The authors say that early use of HPV testing after treatment averts more cases of CIN stage 3 and is cost-saving compared to current practice because it is more effective at early detection of women who are at risk of recurrent disease in future. They add that HPV testing results in fewer colposcopies (a detailed examination of the cervix) over 10 years than cytology only follow-up, and a higher proportion of colposcopies resulted in re-treatment -- an important reduction in the burden of follow-up on women, and also on the health system.

They conclude that HPV 'test of cure' is more effective and less costly than the annual cytology follow-up over 10 years. HPV testing performed six months after treatment effectively "distinguishes women at future risk of serious recurrent cervical disease and supports the full scale implementation of HPV testing as a test of cure after treatment of CIN." They add however that there is a need for ongoing monitoring and evaluation of the long term safety of these strategies.

In the second study, researchers compared the risk of cervical cancer in 38,956 women in the Netherlands who returned to routine screening after completing their cytological post-treatment follow-up for CIN with women with normal cytology results.

They found a fourfold increased risk in treated women (35 cases per 100,000 woman years) compared with 6 cases per 100,000 woman years for untreated women, regardless of age and grade of CIN.

They say their results "have implications for women treated for cervical intraepithelial neoplasia, although how the excess risk could be decreased is not straightforward."

In an accompanying editorial, clinicians from the departments of pathology and epidemiology at the VU Medical Centre in Amsterdam also suggest that cytology and HPV testing at six and 24 months should be sufficient. They agree that post-treatment surveillance should aim at detecting HPV and question whether short-term surveillance "constitutes sufficient follow-up before patient return to the usual screening programme." They suggest there is no evidence to long term intensive monitoring and that "current guidelines [should] be modified."


Story Source:

The above story is based on materials provided by BMJ-British Medical Journal. Note: Materials may be edited for content and length.


Journal References:

  1. R. Legood, M. Smith, J.-B. Lew, R. Walker, S. Moss, H. Kitchener, J. Patnick, K. Canfell. Cost effectiveness of human papillomavirus test of cure after treatment for cervical intraepithelial neoplasia in England: economic analysis from NHS Sentinel Sites Study. BMJ, 2012; 345 (oct31 4): e7086 DOI: 10.1136/bmj.e7086
  2. M. Rebolj, T. Helmerhorst, D. Habbema, C. Looman, R. Boer, J. van Rosmalen, M. van Ballegooijen. Risk of cervical cancer after completed post-treatment follow-up of cervical intraepithelial neoplasia: population based cohort study. BMJ, 2012; 345 (oct31 4): e6855 DOI: 10.1136/bmj.e6855
  3. M. C. G. Bleeker, C. J. L. M. Meijer, J. Berkhof. Follow-up after treatment for cervical intraepithelial neoplasia. BMJ, 2012; 345 (oct31 4): e7186 DOI: 10.1136/bmj.e7186

Cite This Page:

BMJ-British Medical Journal. "Cheaper and more effective test available for women following pre-cervical cancer treatment, study suggests." ScienceDaily. ScienceDaily, 1 November 2012. <www.sciencedaily.com/releases/2012/11/121101184104.htm>.
BMJ-British Medical Journal. (2012, November 1). Cheaper and more effective test available for women following pre-cervical cancer treatment, study suggests. ScienceDaily. Retrieved April 19, 2014 from www.sciencedaily.com/releases/2012/11/121101184104.htm
BMJ-British Medical Journal. "Cheaper and more effective test available for women following pre-cervical cancer treatment, study suggests." ScienceDaily. www.sciencedaily.com/releases/2012/11/121101184104.htm (accessed April 19, 2014).

Share This



More Health & Medicine News

Saturday, April 19, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

'Holy Grail' Of Weight Loss? New Find Could Be It

'Holy Grail' Of Weight Loss? New Find Could Be It

Newsy (Apr. 18, 2014) In a potential breakthrough for future obesity treatments, scientists have used MRI scans to pinpoint brown fat in a living adult for the first time. Video provided by Newsy
Powered by NewsLook.com
Little Progress Made In Fighting Food Poisoning, CDC Says

Little Progress Made In Fighting Food Poisoning, CDC Says

Newsy (Apr. 18, 2014) A new report shows rates of two foodborne infections increased in the U.S. in recent years, while salmonella actually dropped 9 percent. Video provided by Newsy
Powered by NewsLook.com
Scientists Create Stem Cells From Adult Skin Cells

Scientists Create Stem Cells From Adult Skin Cells

Newsy (Apr. 17, 2014) The breakthrough could mean a cure for some serious diseases and even the possibility of human cloning, but it's all still a way off. Video provided by Newsy
Powered by NewsLook.com
Obama: 8 Million Healthcare Signups

Obama: 8 Million Healthcare Signups

AP (Apr. 17, 2014) President Barack Obama gave a briefing Thursday announcing 8 million people have signed up under the Affordable Care Act. He blasted continued Republican efforts to repeal the law. (April 17) Video provided by AP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins