Better, Cheaper, Simpler Test

Cervical cancer screening post treatment may be best with the simpler test

(RxWiki News) For women who have been treated for cervical cancer, the most accurate follow-up test might also be the cheapest. The simpler test checks for the cure rather than the disease.

A recent study did the math on two types of follow-up tests for women after cervical cancer treatments. The findings support simple human papillomavirus testing as cheap and accurate.

"Talk to your doctor about follow-up testing."

Rosa Legood, PhD, professor at the London School of Hygiene and Tropical Medicine in Australia, led an investigative team to evaluate cost-effective follow-up tests after pre-cervical cancer treatment.

Cervical intraepithelial neoplasia (CIN) is the medical term for abnormal and possibly pre-cancerous cervical cells. CIN is caused by the human papillomavirus (HPV).

After treating CIN, follow-up tests are recommended every year for 10 years. But those tests are expensive.

Researchers set out to see if it would be cost effective to test for HPV every year instead of CIN.

CIN cannot occur without the presence of HPV, and the HPV test is less expensive.

For the study, researchers watched the cases of women who went back to regular HPV screening if they had negative HPV test results six months after treatment.

Data was collected from six testing sites in England.

The study’s findings showed 63 percent of women were 35 or younger and treated for mild, or stage 1, CIN.

After treatment for CIN, only 29 in 1,000 women who underwent continued testing for CIN had stage 3, or severe, CIN return over the course of 10 years.

The cost of the CIN testing for those 1,000 women over 10 years was figured at $574,910.

When an HPV-only test was used to test that the women were still cured of CIN, 37 in 1,000 women were re-diagnosed with stage 3 CIN during follow-up testing.

The cost of HPV testing for those 1,000 women over 10 years was $15,067 less than the CIN testing.

Authors concluded, “HPV test of cure would be more effective and would be cost saving compared with cytology only (CIN test) follow-up.”

Researchers also found the need for fewer colposcopies, a biopsy of cervical tissue, with the use of the HPV test instead of the CIN test.

This study was published in November in the British Medical Journal.

Funding was provided by the NHS Cancer Screening Programme.

No conflicts of interest were reported.

Review Date: 
November 15, 2012