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Move to HPV testing for cervical cancer ‘has psychological benefits’

By Lilian Anekwe

A move to HPV testing in the UK would be better for the ‘psychosocial wellbeing' of women compared with conventional repeat smear testing, according to Australian research .

HPV testing for women with borderline cervical abnormalities will soon be introduced into the cervical screening programme in sentinel sites across England and Wales, and is already available in the US, Europe and Australia.

Women with borderline cervical abnormalities account for around 4%, or 100,000 women in the UK every year.

Pulse revealed last month that HPV testing is also set to become the primary screening tool for cervical cancer in women over 35 in the UK, after the chair of the Department of Health's cervical screening advisory group said the move would be ‘very rational'.

His comments came in the light of a study in The Lancet Oncology which suggested HPV testing was better than either cytology alone and HPV testing combined with cytology at detecting cervical abnormalities.

But screening experts said the chief implication for GPs would be counseling women who test HPV-positive and reassuring worried women.

The latest study, published in the BMJ, followed 313 women aged 16 to 70 with a borderline smear who were randomised to one of three triage arms: HPV testing, a repeat smear test at six months, or the patient's informed choice of either test.

After 12 months psychological distress about an abnormal smear was lowest in women allocated to HPV testing and highest in the repeat smear testing group.

Women in the HPV group and the informed choice group were more satisfied with their care than women allocated to repeat smear testing. However, the benefit of giving women an informed choice of either HPV testing or repeat smear testing supported by a decision aid is still uncertain, say the authors.

‘Dr Kristen McCaffrey, senior research fellow in public health at the University of Sydney concluded: ‘The findings suggest that there are no lasting psychosocial disadvantages to HPV triage, and in view of other potential advantages, the findings support the move towards HPV triage in the UK for women with borderline smear results.'

Professor Juiletta Patnick, the director of the NHS cancer screening programmes, said: ‘We have already carried out a pilot scheme in order to analyse how HPV testing can be incorporated into the current cervical screening programme. As such, the programme is currently investigating various benefits, including the psychosocial benefits, along with potential pitfalls of such a scheme. The results should be published in 2010.'

A move from smears to HPV testing would be better for the 'psychosocial wellbeing' of women, say researchers


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