A new method for self-diagnosing HPV could enhance cervical cancer screening.

This method may be crucial for enhancing cervical cancer screening.

The study is based on data from women in the UK who were offered HPV self-testing because they missed their scheduled cervical cancer screening.

“HPV self-testing has become an important component of cervical screening. It reaches women who would otherwise not participate,” says Jiayao Lei, an associate professor at the Department of Medical Epidemiology and Biostatistics and the Department of Clinical Sciences, Interventions and Technologies, and the lead author of the study.

The research conducted in primary care centers in England included 855 women with positive HPV self-test results, indicating the presence of an HPV infection, followed by sample collection and analysis by a healthcare provider. It was found that 71 of these women (8.3%) were diagnosed with severe precancerous changes or cervical cancer.

Further Screening for High-Risk Group

The researchers examined detailed information regarding the HPV test results from self-collected samples and employed a new method to assess the risk of serious cellular changes. Risk stratification was based on the type of HPV virus and the viral load (Ct) present in the self-collected sample. As a result, they categorized the women into three risk groups: high, medium, and low risk. Women with HPV type 16 and a low Ct value (<30) had the highest risk of developing severe precancerous changes or cervical cancer.

Approximately 40% of women in the high-risk group were diagnosed with severe precancerous changes or cervical cancer requiring treatment. Consequently, the researchers recommended that this group be referred for further examination via colposcopy in the future.

More than half of those who tested positive were classified in the low-risk group, where the likelihood of being diagnosed with severe precancerous changes or cervical cancer within 12 months was 4%.

“We believe that the low-risk group can undergo retesting after 12 months, while the moderate-risk group should be referred for further analysis by healthcare providers,” says senior author Peter Sasieni, a professor at Queen Mary University of London.

Benefits of Risk Stratification

One of the main advantages of the new method is that risk assessment can be conducted immediately after HPV self-testing, without the need for additional laboratory analyses.

This could be particularly beneficial for cervical cancer screening in low- and middle-income countries where resources are limited.

Next Steps in the Research

With the support of the Swedish Cancer Society, the researchers will conduct a large-scale population study in Sweden based on self-testing using a different test to evaluate the feasibility of incorporating such risk stratification into standard screening programs. They also plan to explore the prognostic value of the current test results in conjunction with other markers for HPV-positive women.