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A new test to detect the DNA of the human papillomavirus (HPV) in women has been described as a "promising" method of screening for cervical cancer in developing countries.

According to research published inthe October issue of The Lancet Oncology , the new test, careHPV, is 90 per cent accurate at identifying women with precancerous cervical disease.

The test was formulated for developing countries by the non-profit global health organisation PATH, in cooperation with laboratory equipment company QIAGEN.

You-lin Qiao, professor of the Chinese Academy of Medical Sciences, and his colleagues evaluated the test on 2,388 women in the rural Shanxi province of China. Other tests, like cytology screening and visual inspection with acetic acid (VIA), were carried out for comparison.

careHPV detects DNA from 14 different carcinogenic HPV types. It takes two-and-a-half hours or less to get results — meaning testing and treatment could be carried out on the same day — and is easier to perform than existing DNA tests. It does not require running water or electricity.

"This test promises to detect about twice as many women with high-grade dysplasia [advanced precancer] as cytology or VIA, so if the cost to the government is competitive, the careHPV test will have strong advantages," corresponding author John W, Sellors, professor of family medicine at McMaster University, Canada, told SciDev.Net.

Sellors points out that the help of local public health authorities is essential while carrying out such tests in less-developed regions and priority should be given to the promotion of awareness in women 30 years and older in villages.

"The biggest challenge [for applying such a technique in developing countries] will be to educate the health policymakers in each country in order that they understand the various ways to screen women, and the cost-effectiveness and appropriateness of each to these poor settings."

PATH is launching a five-year research project in India, Nicaragua and Uganda to compare careHPV to cytology and VIA so that policymakers there have the data to make evidence-based decisions.

Eighty-five per cent of cervical cancer deaths occur in developing countries, largely due to the lack of effective screening and treatment programmes.

Link to abstract in The Lancet Oncology


The Lancet Oncology 9, 929 (2008)

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