Multiple Options Available for Effective Cervical Cancer Prevention

April 1, 2015

By Hongxiu Ji, M.D., Ph.D.

Once the leading cause of cancer death in women, cancer of the uterine cervix has become a rare disease, thanks to the implementation of prevention programs. In fact, cervical cancer prevention represents the most successful story in cancer control so far.

It is well recognized that cervical cancer follows a stepwise progression model, starting with persistent infection by high-risk types of human papillomavirus (hrHPV), followed by development of cervical precancerous lesions, and progressing eventually to invasive cervical cancer. This process naturally takes years to complete, which gives us the opportunity to intervene at multiple critical points.

Examples of successful intervention include the mass vaccination of preteen boys and girls before they start sexual activity. Currently in the state of Washington, HPV vaccination is widely applied to early middle school age children, which will prevent the occurrence of cervical cancers.

For reproductive age and postmenopausal women, there are several highly sensitive and specific molecular diagnostic methods that detect hrHPV in cervical cytology samples, along with Pap testing that identifies malignant changes in cells. Once a cellular alteration is identified, a colposcopy-guided cervical biopsy can confirm the diagnosis of precancerous lesions. These lesions are easily eradicated by local treatment in an outpatient office setting, which will also prevent the occurrence of invasive cervical cancer.

Currently, several strategies of hrHPV screening are available. These include reflex hrHPV testing for equivocal Pap smear results in young women 21 to 29 years of age, Pap smear and HPV co-testing in women 30-65 years of age, and more recently, primary HPV screening with reflex cytology for women 25 years and older. All of these screening methods aim for maximal patient safety and disease detection, while maintaining minimal discomfort and the lowest economic burden for the patient.

Incyte Diagnostics is one of the major laboratories in hrHPV screening in the Pacific Northwest. We currently offer both hrHPV reflex testing and hrHPV co-testing with Pap smear. Primary hrHPV screening will be available shortly. These options give flexibility to women and their care providers in selecting the most effective method in cervical cancer prevention that is right for them.