Date: Tuesday, February 10th, 2015 Time: 12:00PM PST, 3:00PM EST
For the last 60 years the primary method of preventing cervical cancer in both the U.S. and Europe has been cervical cytology -- if it is negative, women are rescreen in three years and if positive, are referred to follow-up examinations. Although this strategy has led to a tremendous reduction in the incidence of cervical cancer, some significant limitations exist. Cytology has low sensitivity for cervical cancer pre-cursors, has low reproducibility, and does not adequately assess long-term risk. HPV testing added to cytology as a co-test for women 30 years and older increases the sensitivity of cytology and addresses many of its limitation, but also significantly contributes to the complexity of management. In 2014, the FDA approved the first hrHPV test for the use as a primary test for cervical cancer screening for women 25 years and older. More recently, interim guidance was co-published by the Society of Gynecologic Oncology (SGO) and the American Society for Colposcopy and Cervical Pathology (ASCCP) on the use of primary hrHPV testing as an alternative to current US cytology-based cervical screening methods as it was found to provide greater reassurance of low CIN3+ risk than a negative cytology result. Additionally, due to the high prevalence of CIN3+ in women 25-29, for which cytology - the current standard of care - detected fewer than 50% of these cases, primary HPV testing could be imitated as early as age 25. Primary hrHPV screening is a significant scientific and clinical advance in cervical cancer screening as it provides improved reassurance of cancer risk following a negative result than cytology-based screening.
Learning objectives: • Define HPV primary screening. • Discuss key data around HPV primary screening. • Describe new HPV primary screening and management guidance.