New test offered at Yale identifies women at risk for cervical cancer
The Yale Cancer Center is among the first facilities in the nation to be named an HPV Center of Excellence by the DIGENE Corporation, makers of the most sophisticated tests for detecting the human papilloma virus (HPV), a common precursor to cervical cancer.
The designation is awarded to geographically diverse academic centers with a demonstrated level of excellence in gynecologic oncology and women's health. These centers are also among the first in the country to offer the newest HPV DNA testing, which helps physicians identify women who are most at risk of having or developing cervical disease.
The FDA-approved laboratory test detects high-risk HPV infection of the cervix, which is the most important risk factor for cervical cancer in 95 percent of all cases. Used in conjunction with the Pap test, the HPV test helps in determining the best course of treatment for women with slightly abnormal Pap smears.
In women whose Pap smears contain atypical squamous cells of undetermined significance, a positive HPV test reveals if there is risk of an underlying high-grade (pre-cancerous) lesion and if a biopsy should be obtained for definitive diagnosis. A negative HPV test, on the other hand, provides assurances that the risk of cervical cancer in the immediate future is very low, and eliminates the need for colposcopy, a specialized pelvic exam, and biopsy.
"The HPV test adds new sensitivity and specificity to the Pap," says Janet Brandsma, associate professor of comparative medicine at the School of Medicine. "The two tests work well together. When you do both tests, you have more faith in following a patient conservatively if the result of the HPV test is negative, or alternatively, in determining to move forward with biopsy if the result is positive."
In the near future, the HPV test may even be used prognostically for women with normal Pap tests, since the HPV infection precedes the development of a lesion. Recent research indicates that women with high risk HPV and normal Pap smears have a 10 percent chance of developing a cervical lesion within two years.
"The HPV test will assure a lot of women that they do not need colposcopy and biopsy," says Dr. Peter Schwartz, director of the Gynecologic Oncology Research Program at the Yale Cancer Center. "It will also have a significant impact on health care costs by eliminating unnecessary diagnostic tests and treatments."
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