This site is intended for health professionals only

At the heart of general practice since 1960

pul jul aug2020 cover 80x101px
Read the latest issue online

Independents' Day

New technique could help boost cervical cancer screening uptake 

A new molecular-based approach to triaging HPV-positive cervicovaginal samples could pave the way for cervical cancer screening based entirely on self-sampling, researchers have claimed.

A study in this month’s The Lancet Oncology found the molecular technique detected CIN2 or worse on self-sampled specimens as accurately as standard cytology done on physician-collected samples.

Offering self-sampling for HPV testing can increase the number of women willing to take part in cervical screening programmes, but self-collected samples are not suitable for current cell-based tests used to triage those samples that turn out to be HPV positive.

Researchers in The Netherlands invited women who were unwilling to participate in cervical screening to provide a self-collected cervicovaginal sample for HPV testing.

They then randomly triaged the HPV-positive samples with the molecular technique – based on detection of DNA methylation in certain genes – or using standard cytology.

Importantly, the molecular technique was done on the same sample provided at baseline, whereas standard cytology required an additional physician-collected sample.

Out of a total of 46,001 women they invited, 12,819 returned self-sampled specimens, of which 1,038 tested positive for high-risk HPV.

The DNA methylation technique detected CIN2 or worse as sensitively as cytology, the researchers reported.

There were more referrals for colcoscopy in the molecular triage group – 55% were referred, compared with 29% of the cytology triage group.

However, the overall time to diagnosis was much shorter in the molecular group, at an average of 96 days compared with 158 days.

The team concluded: ‘Molecular triage of HPV-positive women by MAL/miR0124-2 methylation analysis on self-collected specimens opens the way to full molecular screening as a feasible alternative for cervical screening by a physician-taken sample.’

Lancet Oncol 2014; available online 14 January

Readers' comments (1)

Have your say