(dailyRx News) Women have received a great deal of conflicting information regarding screening for cervical cancer recently. A clinical trial aims to resolve the confusion.
For women over the age of 30, human papillomavirus (HPV) DNA testing is the best test for cervical cancer. This technology is better than cytology (pap smears) alone in detecting pre-cancerous lesions and preventing more cervical cancer.
These are the findings of the POBASCAM trial, which back up and reinforce the findings from cohort studies, clinical trails and clinical practice, according to Hormuzd Katki and Nicolas Wentzensen from the National Cancer Institute. This trial, they write, provides "overwhelming evidence of the benefits of inclusion of HPV testing in screening programs."
Chris Meijer and colleagues from the VU University Medical Centre, Amsterdam led the POBASCAM trial involving 45,000 women aged 29 to 56 who received routine cervical screening in the Netherlands. Researchers examined results of multiple screenings and analyzed results to determine the best age to start HPV testing.
Women were randomly selected to have either HPV DNA testing along with cytology, or cytology alone. Five years later, at the second screening, all women received both HPV and cytology tests.
In the first screening, HPV testing identified significantly more cancer precursors - defined as cervical intraepithelial neoplasia grade 2 or worse (CIN2+) - than cytology alone. Five years later, substantially fewer women who had received the HPV testing had CIN3+ lesions and cervical cancer than women who only had pap smears.
The authors say this study demonstrates that HPV DNA screening helps protect women against high-grade lesions that can develop into cervical cancer. This enhanced protection was due in large part to early detection of lesions caused by HPV16 - a major HPV type that causes cancer. This indicates that HPV could eventually reduce cervical cancers and deaths from the disease.
The final results of the POBASCAM trial, published Online First December 15, 2011 in The Lancet Oncology.