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Repeat testing for high-risk strains of human papillomavirus, including home-based self-collection of the sample, can reduce the number of women referred for unnecessary follow-up procedures, suggests a new study.
In Uppsala County, Sweden, 7,331 eligible women who had not undergone cervical screening in six or more years were offered the opportunity to self-sample vaginal fluid at home and return the sample for HPV testing. In all, 39 percent completed the self-sampling (2,850), and high-risk HPV was found in 6.6 percent (188).
The 188 women testing positive were invited for a follow-up HPV test and cervical biopsy; 89 percent accepted (an average of 2.7 months later). Fifty-nine percent remained HPV-positive at the second test. On examination, cervical intraepithelial neoplasia 2+ (CIN2+) lesions were seen in 23 percent of women who had one positive HPV test. CIN2+ prevalence was 41 percent among women with two consecutive positive HPV tests, ranging from 49 percent among women ages 30-39 to 24 percent for ages 50-65.
Short-term repeat HPV testing boosted specificity for detection of CIN2+ lesions from about 94.2 percent to 97.8 percent, noted professor Ulf Gyllensten, Uppsala University, and colleagues.
This study confirms previous evidence that repeating the HPV test reduces the number of women who are sent for other more invasive tests, when in fact they do not have any serious cervical changes on further examination, said Gyllensten. This still works if women are able to do the first test at home, which can help overcome some of the emotional and physical barriers to cervical screening.
The full study, Short-Time Repeat High-Risk HPV Testing by Self-Sampling for Screening of Cervical Cancer, was published in the British Journal of Cancer (2011;105:694-697).
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