09 January 2020

We Will Beat Cervical Cancer.

By Eleanor Doolin

Cervical cancer is a battle that we can win.

While it remains the fourth most common type of cancer for women worldwide, it is one of the most preventable and curable with early diagnosis.

Almost all cases of cervical cancer are caused by HPV. There are 130 types of HPV, but the two strains responsible for cervical cancer are HPV 16 and HPV 18.

Increased accessibility to HPV vaccinations is one way global healthcare is saving women’s lives today.

That’s why schemes like the NHS’s childhood immunisation programme are invaluable. With this, the HPV vaccine is routinely given to girls when they're 12 to 13 years old, with two doses given over a six-month period. It is also available free on the NHS to all girls up to their 18th birthday.

The HPV vaccine significantly reduces the risk of cervical cancer; however, it can’t guarantee that you’ll never develop the condition. Plus, its accessibility varies globally. This means cervical screening tests are still crucial, even if you've had the vaccine.

Cervical cancer has no symptoms in its early stages. When symptoms do manifest, it can be too late with the cancer advancing or spreading.

Many healthcare systems, like the NHS, use a screening test that looks for changes to cells in the cervix. However, it’s been reported that an HPV test which looks for the presence of the virus could be more efficient.

A study from Canada found that an initial test for human papilloma virus (HPV), led to the discovery of more pre-cancerous lesions than you’d find with a conventional smear test.

While a move to these HPV tests would find more cases of pre-cancerous lesions in patients, there’s also a risk this would increase "false positive" results. This means that women with HPV but no cancerous changes would be referred for further investigations – causing unnecessary worry and distress.

Back in 2018, market leader Roche were the first to have an HPV test FDA approved for use as a primary (first line) screening test. Their cobas HPV test is made-up of SurePath and ThinPrep PreservCyt Solution, the two types of liquid media used to collect samples for most of the Pap or HPV tests in the US.

Hologic have also had a positive impact, bringing to market the first FDA approved liquid-based cytology option in cervical disease screening. This is the preferred choice of test in the US, accounting for over 80% of tests.

Smaller players are helping us beat cervical cancer too. DiaCarta have a QuantiVirus HPV mRNA E6/E7 which, like most mRNA assays, provides higher specificity than DNA-based assays. They also offer more accurate correlation of HPV infection and potential cancer development. Plus, they have higher sensitivity (>90%) and superior specificity (>90%) compared to Qiagen’s HC2 test.

There are many advanced cancer screening programs being put in place around the world, with this technology working effectively. Although this is great, there’s still an issue with people staying up to date with their screening - especially in the US.

According to multiple studies, women with low income, less education, a lack of health insurance, older age, smoking status and obesity are falling behind on their screenings. This could cost them their lives. While advanced technology is helping many women beat cervical cancer, there’s still a lot of work to be done on social issues, awareness and accessibility.

We’re moving in the right direction and cervical cancer is a battle that we will win, but we need to make the most our screening programs and the brilliant diagnostics technology out there.

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By Eleanor Doolin

Eleanor Doolin works as a Senior Consultant broadly within IVD but has previously spent time focusing specifically in clinical chemistry and oncology, plus advances in non-invasive diagnostic testing. She is always looking to connect with innovative individuals and organisations working in this area.

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