Test Improves Sensitivity of Cervical Cancer Detection

Overexpression of p16-INK4A improves sensitivity compared with cytology

THURSDAY, Sept. 11 (HealthDay News) -- Overexpression of a protein associated with viral infection and cell growth in women positive for human papillomavirus (HPV) can improve the sensitivity of cervical cancer detection compared with conventional cytology, according to the results of a study published online Sept. 9 in The Lancet Oncology.

Francesca Carozzi, Ph.D., from the Centre for Cancer Study and Prevention in Florence, Italy, and colleagues randomly assigned 49,196 women to either conventional cytology or stand-alone HPV testing and referred for colposcopy. Of the 24,661 women receiving HPV testing, 1,137 (including 92 with grade 2 or 3 cervical intraepithelial neoplasia) had valid immunostaining for p16-INK4A.

The researchers found that p16-INK4A detected grade 2 or greater cancer in HPV-positive women with a sensitivity of 88 percent and a specificity of 61 percent. In women aged 35 to 60 years, the relative sensitivity was 1.53 and the relative referral for colposcopy was 1.08 for HPV testing and p16-INK4A triage compared with conventional cytology, the investigators report. For women 25 to 34 years old, the corresponding numbers were 3.01 and 1.15, respectively.

"HPV testing with p16-INK4A triage produces a significant increase in sensitivity compared with conventional cytology, with no substantial increase in referral to colposcopy," Carozzi and colleagues conclude.

Carozzi and another study author report financial relationships with the pharmaceutical industry.

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