New test detects hard-to-find cervical cancer.
New test detects hard-to-find cervical cancer.
[Title]: Breakthrough Test Detects Elusive Cervical Cancer, Saving Lives
With a touch of humor and an optimistic tone, scientists at Montefiore Einstein Cancer Center in New York City have unveiled a groundbreaking test that is set to revolutionize the detection of cervical cancer. This new test, while providing a much-needed advance in detection, focuses on a type of cervical cancer often missed by the standard Pap test. Dr. Howard Strickler, a researcher at the cancer center, explains that the new test is “sensitive for detecting cervical adenocarcinoma [ADC] – which now accounts for up to 25% of cervical cancer cases – as well as its precursor lesions, adenocarcinoma in situ [AIS], that often develop into ADCs.” Early detection of ADC is crucial, as this form of cancer has higher death rates compared to the more common cervical squamous cell cancer. Currently, the Pap test, despite its effectiveness in reducing cases of squamous cell cancer over the past six decades, falls short in detecting ADC.
The Challenge of Detecting Cervical Adenocarcinoma
While the Pap test has played a pivotal role in cervical cancer screening, it is less effective when it comes to detecting ADC. This has led to a steady persistence of ADC cases. However, with recent advancements, testing for human papillomaviruses (HPVs) has become a standard screening tool, alongside the Pap test. It is important to note that HPVs are responsible for almost all cervical cancer cases, with HPV 16, 18, and 45 accounting for over 70% of these cases and over 90% of ADC cases. Consequently, current HPV tests aid in identifying women at high risk for cervical cancer.
A New Insightful Test: Assessing Methylation Levels
With many women already beyond the age for receiving the cervical cancer vaccine, screening and treatment remain crucial for preventing cervical cancer. Enter the groundbreaking test developed by the Montefiore Einstein Cancer Center. The test assesses HPV 16, 18, and 45 using a unique approach, focusing on methylation levels. Methylation involves DNA modifications and has significant influence in altering gene expression.
In a study involving 1,400 women who underwent cervical cancer screening at Kaiser Permanente Northern California, the researchers examined methylation levels in cervical tissue samples. By analyzing the methylation percentages for 35 viral-genome sites and assigning an average score, the researchers were able to identify women with high methylation scores. These women had increased odds of having developed either ADC or AIS. Dr. Robert Burk, co-lead of the study, elaborates on the significance of these findings, stating that “women with a high methylation score may benefit from colposcopy and specialized tissue evaluation, beyond just a Pap test, which could lead to early diagnosis and treatment for ADC or the removal of AIS lesions before they develop into ADC.”
Bridging Health Disparities and Expanding Access to Testing
The implications of this breakthrough test go beyond its accuracy and reliability. It has the potential to bridge health disparities and increase access to cervical cancer screening, especially in lower- and middle-income countries burdened with a high prevalence of cervical cancer. In countries like sub-Saharan Africa, where HIV-HPV coinfections are common, the need for effective screening is paramount.
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Even in developed nations like the United States, health disparities exist, as seen in the higher cervical cancer rates in the Bronx compared to Manhattan. The new HPV methylation test aims to address such disparities by providing more frequent and effective screening. Dr. Strickler believes that this test could be done once every three to five years and hopes that it will contribute to increased cervical cancer screening equity in the United States.
Conclusion
The emergence of this breakthrough test offers new hope in the fight against cervical cancer. By targeting cervical adenocarcinoma often missed by the Pap test, this innovative approach brings us a step closer to early detection and ultimately saving lives. Not only will the test prove invaluable in developed countries, but it also has the potential to increase screening equity in lower-resource settings. As research and clinical trials affirm the test’s efficacy, it is poised to become a significant tool in the global battle against cervical cancer.
Source: Montefiore Einstein Cancer Center, news release, Sept. 7, 2023
