‘Catch up’ HPV test may benefit older women

Encouraging never-screened women over the age of 65 to have a human papillomavirus (HPV) test ‘significantly’ increases detection of cervical pre-cancer lesions, a new study has found.
 
The Danish research, published in PLOS Medicine, tracked nearly 45,000 women aged 65–69 over a 12-month period, including all those who had no record of cervical cancer screening in the preceding five-and-a-half years and no record of an HPV test at ages 60–64.
 
The cohort was separated into two groups, with 11,192 being invited to participate in HPV-based cervical cancer screening, while the remaining 33,387 were assigned to a control group which received no screening invitation but could have an opportunistic cervical cytology sample collected for whatever reason.
 
Among women in the intervention group, 6965 (62.2%) were screened within 12 months, compared to only 2.2% of women in the control group. Nearly four cases (3.9) of cervical intraepithelial neoplasia grade two or worse (CIN2+) were detected per 1000 eligible women in the former group, compared to only 0.3 cases per 1000 in the latter.
 
Meanwhile, the research also found that women who have been insufficiently screened at age 50–64 had higher HPV prevalence and tended to have more CIN2+ lesions diagnosed compared to sufficiently screened women.
 
According to the researchers, led by cancer epidemiologist Dr Mette Tranberg, the study also demonstrated that insufficiently screened women are more likely to request vaginal self-collection, a cervical screening option recently introduced in Australia that is becoming increasingly popular.
 
‘A catch-up HPV screening test could potentially improve cervical cancer prevention in women aged 65 years and older who have never had an HPV test,’ Dr Tranberg said.
 
‘Older insufficiently screened women were more likely to self-collect a vaginal sample for HPV testing in their own home as compared to sufficiently screened women; hence this screening modality could be ideal to identify older women at risk of cervical cancer.’
 
In Australia, which is attempting to eliminate cervical cancer by 2035, 72% of cervical cancers occur in women who have never screened or who are lapsed screeners, despite this cohort comprising only 45% of those eligible for testing.
 
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