Published: Sat, July 07, 2018
Medicine | By Melba Vasquez

Variation in Genetic Testing Rates Seen for Patients with Breast Cancer

Variation in Genetic Testing Rates Seen for Patients with Breast Cancer

The study results showed that the human papillomavirus test is more sensitive than the widely used but often flawed method of performing a regular Pap smear, and several experts are predicting a strong push to replace Pap smears with simple HPV testing. He said that physicians will have to make the choice between HPV testing and co-testing based on cost-effectiveness studies and their own discretion, while continuing to improve outreach for underserved and inadequately screened women to combat such high rates of cervical cancer. Pap smear and HPV testing market can be classified into five major segments, namely, monoclonal and polyclonal antibodies, immunoassays, molecular diagnostics, chromosomal analysis, and other analyses.

"Most cases of cervical cancer happen in women who have not been regularly screened, or who have been screened, but don't have access to appropriate treatment", she says.

Dr. Ogilvie added that, "So this study is the next step, showing that by using only HPV testing in a screening scenario, four years later, women who received HPV testing were less likely to develop precancerous lesions".

The National Cancer Institute's Mark Schiffman, who has done extensive research on HPV, said the study confirmed that it's important to move from the Pap smear to the HPV test alone.

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There's a vaccine that prevents most cancer-causing strains of HPV, but once a person has become sexually active, it's too late to get it. However, major organizations, such as the American Society of Clinical Oncology, have called for clinical trials involving HPV testing alone for more than 1 round of screening to further inform the implementation of the screening. Where it is hard to apply HPV tests over pap smear for USA as there hasn't been head to head comparison until now.

For more on cervical cancer screening, visit the American College of Obstetricians and Gynecologists. They focused mainly on moderate or severe changes to cervical cells (pre-cancerous changes) that could lead to cervical cancer. "The real benefit of co-testing is with the HPV test", she said.

They also cautioned that more work needs to be done to assess the economic consequences of changing the screening model.

Women with positive HPV or smear tests had their samples immediately analysed using the other test and then had a colposcopy if results showed both HPV and changes to cells. Consistent with prior studies, more cases of abnormal cells in the cervix, known as cervical intraepithelial neoplasia (CIN), grade 3 or worse (CIN3+), were detected in the intervention group compared with the control group in the first round of screening. This type of cancer is mostly caused by the human papillomavirus (HPV), in as much as 99% of all cases.

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In the first round of screening at the start of the study, more cases of CIN3+ were found in women who had HPV tests (7 per 1,000 women) than women who had smear tests (4.4 per 1,000 women). According to the article, the researchers surveyed 5080 women treated for early-stage breast cancer by 377 surgeons in Georgia and Los Angeles between 2013 and 2015.

"This supports the small, but significant benefit of co-testing". HPV test is more accurate, leads to earlier diagnosis and also increases the interval between screening.

Of note, the Canadian Task Force on Preventative Health Care differs from the US task force - it recommends Pap smear screening every three years between ages 30 and 69, citing weak evidence for screening women ages 25 to 29.

Patients with breast cancer may be missing out on genetic tests that could pinpoint the ideal treatment regimen, despite current practice guideline recommendations, Reuters reported.

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Medical students learn how to insert a speculum, part of the process of performing a Pap smear.

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