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Pictogramme horloge March 2014

Screening for high-risk oncogenic HPV types (HPV-HR) via the amplification of nucleic acids (NAAT) is a highly efficient tool in the prevention of cervical cancer if it us used properly.

There are approximately 120 HPV genotypes, of which only 15 or so (HPV-HR) are associated with cervical cancer.

Cervical cancer is classed as the 8th cause of cancer in women in France aged between 45 and 55 years and it is responsible for 1000 deaths per year. HPV infections are frequent and very contagious. Some 75% of women are infected at least once in their life. These infections are generally transitory and benign; it is the persistence of HPV infection over several years that can lead to the development of cervical cancer. When considering the virus’ epidemiology, HPV-HR should not be screened for in patients under the age of 30. Screening should also only be performed following a borderline or ASCUS pap smear result. Screening for a HPV-HR infection is only included in France’s list of nomenclature for medical and biological acts within the scope of this situation and given the excellent negative predictive value for the HPV test. This strategy enables women to be selected accordingly, i.e. those who need to undergo complementary testing (colposcopy). Although HPV-HR genotype testing is not currently recommended, Biomnis has chosen to offer real-time PCR testing on the Cobas® 4800 HPV analyser (Roche® Diagnostics). This test has excellent clinical specificity and sensitivity and allows for the detection of 14 high-risk HPV genotypes (HPV 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66 and 68) as well as the selective typing of types 16 and 18.

Numerous studies have shown the specific implication of the genotypes 16 and 18 in the number of infections, the persistence of infection in the organism and the development of cervical cancer.

At present, different screening strategies (pap smear followed by HPV testing, combined screening, HPV-HR primary screening etc.) that integrate, or otherwise, partial typing are being assessed. In cases where an ASCUS smear result was obtained, please note that the HPV test must be performed in the Preservcyt® (Hologic) or SurePathTM (TriPath Imaging Inc) liquid cytology media that was used to collect the pap smear sample.

References

Article reviewed in August 2017