Women at high-risk for human papillomavirus (HPV) infections are now one step closer to getting timely screening and same-day treatment. A new report indicated that self-sampling combined with a high-speed diagnostic HPV test is just as effective as clinician-collected samples. This combination may be particularly beneficial for women in Papua New Guinea, in whom the incidence of HPV-associated cancers is among the leading cause of premature death.
The human papillomavirus (HPV) is the most common sexually transmitted virus. Most infections go undetected, while some can cause genital warts. Even scarier, this virus is one of the few that is known to cause cancer – most notably, cervical cancer. Fortunately, vaccination and preventative screening are highly effective at catching HPV infections before it leads to precancerous lesions that then develop into cancer.
However, for women in low-income high-risk parts of the world, like that of Papua New Guinea, preventative screening can be hard to accomplish. "The majority of the country's population live in rural communities, many of which are very isolated," explained Andrew Vallely, Associate Professor at the University of New South Wales, Sydney, Australia. In underdeveloped countries such as Papua New Guinea, patients don’t have the opportunity to come to the clinics regularly, and clinicians can’t often reach their patients again once they leave the clinic. This becomes highly problematic when patients leave the clinic’s care before they can be properly treated for their HPV infection.
To address this issue, clinicians have turned to self-collected vaginal swabs and a faster, automatic HPV diagnostic test called the Xpert HPV Test. The self-sampling method bypasses laborious pelvic examinations conducted by healthcare workers. This allows more women to be screened for HPV in a single day, and also relieves the burden for the healthcare staff.
After the specimens are collected, they are tested for presence of HPV using the Xpert HPV Test, which is fully automated and provides accurate diagnoses. Between self-sampling and the new diagnostic assay, women can receive same-day results, which mean they can be treated appropriately before leaving the clinic. If HPV-positive, the women undergo a cervical exam and treatment to remove the lesions via cryotherapy. Women whose exams reveal advanced malignancies are referred to specialists immediately.
"By readily identifying women who have a high risk HPV infection, this clinic-based self-sampling strategy would allow health services in low-income settings such as Papua New Guinea to focus their efforts on those women who are most at risk of cervical pre-cancer and cancer," said Vallely.
The research team attributes these benefits to self-sampling, as it allows more women to be screened daily with same-day results. And self-sampling is just as effective as clinician-collected samples, meaning there’s no compromise in the integrity of the specimens. "This is the first time there's been a direct comparison between self-collected vaginal swabs and clinician-collected cervical specimens using a screening device that can provide same day results," said Vallely.
Additional source: American Society for Microbiology