Vanishing virus may prevent over-treatment for cancer

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Vanishing virus may prevent over-treatment for suspected cervical cancer

LONDON

By health-newswire.com

A " wait and see " six-month policy should be employed for women testing

positive for the high-risk form of human papillomavirus (HR-HPV) and with an

abnormality in cervical smears, say researchers from the Netherlands.

A minority of women infected with HR-HPV develop cervical cancer and most

pre-malignant lesions regress spontaneously. Doctors are concerned that this

leads to most women with abnormal cervical cytology being over-treated.

Professor Chris Meijer, from the Departments of Pathology, Vrije

Universiteit Medical Centre, Amsterdam and his team used results from

previous research to find out whether disappearance of HR-HPV could predict

cytological regression of pre-malignant cervical cells.

The research team investigated 353 women referred for colposcopy because of

abnormal cervical smear test results. To avoid interference with the natural

course of the disease, no biopsy samples were taken during the study.

The women were followed up by cytology, colposcopy and testing for HR-HPV

every three to four months. Researchers classified the women as being clear

of infection when there was no sign of HR-HPV from one visit to another.

Results clearly showed that HR-HPV clearance preceded regression of cervical

lesions by an average of three months. The cumulative one-year rate of

cytological regression was similar in women with mild and moderate abnormal

cervical smears.

The study authors conclude that re-testing HR-HPV after a period of six

months in women with mild to moderate abnormal cervical smears predicts

cervical regression.

" We suggest that over-treatment in women with abnormal smears could be

prevented by implementing a wait-and-see period to allow high-risk HPV

clearance and subsequent regression of the lesion, " they said.

A spokesperson for the Cancer Research Campaign said the report was an

interesting addition to current knowledge about smear testing and HPV

infection.

He said the national cervical screening programme had been successful in its

primary aim of reducing the numbers of cases of invasive cervical cancer -

the cancer incidence fell by 42 per cent between 1990 and 1996. However, he

said the potential for over-treatment of women with smear test results

showing only mild or moderate cell changes was worrying.

" Any approach that could help to reduce this unnecessary treatment would be

welcomeThe Cancer Research Campaign has always been concerned that

introducing HPV testing into the screening programme would result in further

over-treatment of women who have had an abnormal smear result but will not

go on to develop a cervical cancer, " he said.

Source: Vrije Universiteit Medical Centre, Amsterdam, Netherlands.

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