HPV test best for CIN surveillance
medwireNews: Testing women for the human papillomavirus (HPV) after treatment for cervical intraepithelial neoplasia (CIN)3 is the best strategy for preventing recurrent disease, UK researchers say.
Analysis of data from the English NHS Cervical Cancer Screening programme indicates that the standard guideline of returning women to the screening programme after clear cytology results 6, 12, and 24 months after CIN treatment would result in 29 residual cases of recurrent CIN3+ per 1000 women over 10 years.
But combining an HPV "test for cure" with a single clear smear test 6 months after treatment could prevent 8.4 more cases of recurrence per 1000 women treated, as well as reducing the treatment costs of £ 358,222 per 1000 women treated by an estimated £ 9388.
"The results of this evaluation support the full scale implementation of [HPV] test of cure after treatment of CIN within the NHS Cervical Screening Programme," write Rosa Legood (London School of Hygiene and Tropical Medicine, UK) and co-authors in the BMJ.
A second study in the same issue demonstrates the importance of following up women with CIN, finding that Dutch women treated for the disease were 4.2 times more likely to develop cervical cancer than those with a clear smear test, regardless of age or CIN grade.
In an editorial accompanying the two research papers, Maaike Bleeker (VU Medical Center, Amsterdam, the Netherlands) and co-authors say that enough evidence exists for guidelines on CIN surveillance to be modified.
"Short-term monitoring post-treatment of women with combined HPV testing and cytology at 6 months and 24 months seems to be sufficient to detect post-treatment cervical disease. After this time, adequate follow-up would be provided by a return to the national screening programme," they write.
medwireNews (www.medwire-news.md) is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2012
By Lynda Williams, Senior medwireNews Reporter