CK Birla Hospital for Women, Gurgaon, India.
The current and future application of HPV genotyping in clinical medicine.
A brief scientific session only for Gyn/Obs faculty on December 23, 2017 at CK Birla Hospital for Women, Gurgaon on role of HPV test and its clinical benefit. The entire session was focused on evidence based scientific management for HPV infected cervical cancer cases.
Why HPV? WHO guidelines for screening and treatment of precancerous lesions for cervical cancer prevention:
Remarks: HPV or VIA
The benefits of screen-and-treat with an HPV test or VIA, compared to no screening, outweighed the harms, but the reductions in cancer and related mortality were greater with an HPV test when compared to VIA. The availability of HPV testing is resource-dependent and, therefore, the expert panel suggests that an HPV test over VIA be provided where it is available, affordable, implementable, and sustainable over time.
Summary of the evidence: CIN2+ ?
Evidence showed that there may be fewer CIN2+ recurrences with the HPV test strategy (3/1000 fewer), as well as fewer cervical cancers (1/10 000 fewer) and fewer deaths (6/100 000 fewer) than with cytology followed by colposcopy. These differences result from fewer missed cases of CIN2+ with the HPV test strategy (i.e. fewer false negatives). Overtreatment, however, may be slightly greater with an HPV test when compared with cytology followed by colposcopy without biopsy (7/100 more women) or with biopsy when indicated (10/100 more women).
Future clinical application of HPV genotyping: HPV genotyping using self-collected samples might be an option to reduce costs and increase patient participation in HPV screening programs.
Special thanks to Dr. Astha Dayal for coordination and Dr. Aruna Kalra, Faculty – Obstetrics & Gynaecology at CK Birla Hospital, Gurgaon for sharing her knowledge on HPV infected patient management.
December 23, 2017.
Clinical significance of human papillomavirus genotyping. J Gynecol Oncol. 2016 Mar;27(2):e21. doi: 10.3802/jgo.2016.27.e21.