Can we apply new methods to better follow up HPV-positive women?

Methylation analysis for increased accuracy of cervical cancer precursors requiring treatment and reduced overtreatment related to HPV-based screening
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Research has shown that with the help of a new type of test, so-called "methylation test", it may be possible to "sort" samples that in a screening context are positive for human papillomavirus (HPV) and predict the risk of cervical cancer in the future. Due to the fact that cervical cancer is caused by long-term HPV infection, the National Cervical Screening Programme is now switching from cytology to HPV testing as primary screening. The HPV test is very sensitive when it comes to identifying precursors to cervical cancer, but we also need more knowledge about how we can distinguish between "dangerous" and "harmless" HPV infections. Only a small proportion of HPV infections and low-grade precancerous lesions develop into deadly cervical cancer, while most cases spontaneously return to normal.

New tests promise improved screening, but how safe and accurate are these analyses for women in Norway?

To gain more knowledge in this field, we will perform an additional methylation analysis on samples collected earlier in connection with mapping the HPV prevalence in Norway before and after the introduction of the HPV vaccine. The two new tests (GynTect from the company Oncgnostics and Qiasure from the company Qiagen) that will now be used in this research project are considered best suited for possible future implementation of the method in the Cervical Screening Programme. Thanks to the fact that we can use already collected biobank material and existing analysis results and data from registers, we can test the accuracy of these tests relatively quickly and without risk.

How do we know that a given HPV infection in a screening sample is the cause of precancerous or cervical cancer many years later?

This is another important question that we want to find an answer to. Cancer development takes time, and it is natural to think that there is a real connection. We are able to confirm this claim by comparing the prevalence of HPV types in the original Pap smear with HPV in the tissue samples, in cases where cervical cancer or precancerous lesions have been detected. The additional analyses will not entail any personal burden for the participants, or have any consequences for further health care. 

To you as a participant

Samples from a small number of participants from the project "Study on the prevalence of human papilloma virus (HPV) in Norwegian women participating in the mass screening against cervical cancer: before the introduction of HPV vaccination" are now also being used to investigate whether a new test, methylation analysis, can increase the accuracy of the HPV screening that has recently been introduced in the Cervical Screening Programme. In addition, the prevalence of HPV types in tissue samples is mapped in cases where precancerous or cervical cancer is diagnosed afterwards. Tissue samples are routinely taken as part of the treatment of precancerous or cervical lesions, and stored in pathology laboratories. We will therefore not need new samples from you.

Reservation against research

If you wish to opt out of participating in our research, please write to us:  

Mari Nygård, PO Box 5313 Majorstuen, 0304 Oslo

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