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Researchers Propose Improved Cervical Cancer Screening
Date:9/21/2009

New method uses risk estimation to guide management, experts say

MONDAY, Sept. 21 (HealthDay News) -- A new tool to determine a woman's risk of developing cervical cancer is being developed by researchers at the U.S. National Cancer Institute.

Their proposal appears as a Keynote Comment article in the Sept. 20 online edition and in the November print issue of The Lancet Oncology.

Cytology (cell testing) is the current first-line method of cervical cancer screening. If the results are abnormal, women undergo repeat cytology, or carcinogenic human papillomavirus (HPV) DNA testing, or are referred directly for a colposcopy, during which biopsies are taken from apparent lesions.

Complex consensus management algorithms are used to determine treatment, but these algorithms are becoming increasingly complex as new technologies become available, the researchers said in a news release from the journal.

"Instead of providing clinicians with algorithms, we propose to provide clinicians with their patient's risk of developing cervical cancer. As a surrogate for cervical cancer, we propose to use cervical precancer, best defined as histological cervical intraepithelial neoplasia grade 3 (CIN3) or more severe (CIN3+), or less precisely by CIN2+, a common treatment threshold," wrote Hormuzd A. Katki and colleagues.

The study authors noted that large amounts of data on risk of cervical precancer are being produced by clinical trials. This risk can be calculated when women are screened for cervical cancer, for those sent immediately to colposcopy, or at one-year, two-year, or three-year follow-up intervals.

"The risk of cervical precancer is a unifying concept to guide management, regardless of which combination of tests a woman has undergone, because risk of cervical precancer boils down to a complex battery of test results over time into a single percentage that forms a basis for action," the
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