Combining Two Diagnostic Tests Drastically Reduces Cancer Miss Rates
|
By LabMedica International staff writers Posted on 17 May 2016 |
|
Image: A photomicrograph of an abnormal Pap smear showing changes consistent with Human Papilloma Virus (HPV) and Mild Dysplasia. Note the irregular perinuclear cytoplasmic clearing, which is the key characteristic of identifying HPV visually on a Pap smear (Photo courtesy of Dr. Cynthia D Booth, MD).
The Papanicolaou (Pap) test is recommended for women between 21 and 65 years old as a screening test for cervical cancer. Women 30 and older who are negative on co-testing may wait as long as five years for their next testing, but physicians still recommend annual examinations.
In recent years, high-risk human papillomavirus (hrHPV) testing for triaging atypical squamous cells of undetermined significance and co-testing with cytology have been implemented in clinical practice. However, clinical data for primary screening with human papillomavirus (HPV) testing alone are currently lacking.
Scientists at the Houston Methodist Hospital (Houston, TX, USA) and their colleagues retrospectively reviewed the correlation of cytology, histology, and hrHPV testing through the use of a cytology laboratory quality assurance database with 130,648 Papanicolaou (Pap) tests interpreted at the BioReference Laboratories (Houston, TX, USA) and Houston Methodist Hospital between March 1, 2013, and June 30, 2014. Among the 47,499 patients who had undergone cytology-HPV co-testing, 1,654 underwent follow-up biopsies.
The sensitivities of the hrHPV and Pap tests were 80.8% and 81.2%, respectively, for detecting any type of cervicovaginal dysplasia and 91.3% and 90.9%, respectively, for high-grade cervicovaginal lesions. For the 253 biopsy-confirmed high-grade cervicovaginal lesions (cervical intraepithelial neoplasia grade 2+, adenocarcinoma in situ, or carcinoma), the false-negative rates for hrHPV and Pap tests were 8.7% and 9.1%, respectively. When they combined the tests, the teams found only three of the 253 cases were double negatives for both the Pap and hrHPV test. Therefore the false-negative rate for cytology-hrHPV co-testing was only 1.2%.
Dina Mody, MD, director of cytopathology at Houston Methodist Hospital and co-author of the study said, “We have known that neither test is perfect and misses a certain number of cases, but we did not realize until we analyzed the data just how impactful the combination of these tests would be. The numbers tell me that Obstetrics and Gynecology specialists need to regularly offer co-testing, and woman age 30 or older need to proactively request co-testing.” The study was published in the May 2016 issue of the journal Cancer Cytopathology.
Related Links:
Houston Methodist Hospital
BioReference Laboratories
In recent years, high-risk human papillomavirus (hrHPV) testing for triaging atypical squamous cells of undetermined significance and co-testing with cytology have been implemented in clinical practice. However, clinical data for primary screening with human papillomavirus (HPV) testing alone are currently lacking.
Scientists at the Houston Methodist Hospital (Houston, TX, USA) and their colleagues retrospectively reviewed the correlation of cytology, histology, and hrHPV testing through the use of a cytology laboratory quality assurance database with 130,648 Papanicolaou (Pap) tests interpreted at the BioReference Laboratories (Houston, TX, USA) and Houston Methodist Hospital between March 1, 2013, and June 30, 2014. Among the 47,499 patients who had undergone cytology-HPV co-testing, 1,654 underwent follow-up biopsies.
The sensitivities of the hrHPV and Pap tests were 80.8% and 81.2%, respectively, for detecting any type of cervicovaginal dysplasia and 91.3% and 90.9%, respectively, for high-grade cervicovaginal lesions. For the 253 biopsy-confirmed high-grade cervicovaginal lesions (cervical intraepithelial neoplasia grade 2+, adenocarcinoma in situ, or carcinoma), the false-negative rates for hrHPV and Pap tests were 8.7% and 9.1%, respectively. When they combined the tests, the teams found only three of the 253 cases were double negatives for both the Pap and hrHPV test. Therefore the false-negative rate for cytology-hrHPV co-testing was only 1.2%.
Dina Mody, MD, director of cytopathology at Houston Methodist Hospital and co-author of the study said, “We have known that neither test is perfect and misses a certain number of cases, but we did not realize until we analyzed the data just how impactful the combination of these tests would be. The numbers tell me that Obstetrics and Gynecology specialists need to regularly offer co-testing, and woman age 30 or older need to proactively request co-testing.” The study was published in the May 2016 issue of the journal Cancer Cytopathology.
Related Links:
Houston Methodist Hospital
BioReference Laboratories
Gold Member
Antipsychotic TDM Assays
Saladax Antipsychotic Assays
New
Automatic Chemiluminescence Immunoassay Analyzer
Shine i2000
Autoimmune Disease Diagnostic
Chorus ds-DNA-G
Latest Molecular Diagnostics News
- Brain Inflammation Biomarker Detects Alzheimer’s Years Before Symptoms Appear
- First-of-Its-Kind Blood Test Detects Over 50 Cancer Types
- Routine Blood Draws Could Detect Epigenetic Biomarkers for Predicting Cardiovascular Disease Risk
- Single Cell RNA Sequencing Could Enable Non-Invasive Blood Disorder Diagnosis
- Blood Test Identifies HPV-Associated Head and Neck Cancers 10 Years Before Symptoms
- Giant DNA Elements Discovered in Mouth Could Impact Oral Health
- Simple Blood Test Spots Disease Through Metabolic Distortion
- Simple Blood Test Could Streamline Early Alzheimer's Detection
- Unique Microbial Fingerprint to Improve Diagnosis of Colorectal Cancer
- ELISA-Based Test Uses Gynecologic Fluids to Detect Endometrial Cancer
- Comprehensive Tumor Profiling Kit Decentralizes and Standardizes Oncology Testing
- Automated Syndromic Testing System Combines Unparalleled Throughput with Simple Workflow
- Simple Urine Test Assesses Risk of Kidney Cancer Recurrence at Early Stage
- Molecular Map Reveals Previously Hidden Connections Between Diseases
- Novel Urine-Based Test Detects Prostate Cancers
- MRD Testing Can Identify Breast Cancer Survivors at Higher Risk of Recurrence
Channels
Clinical Chemistry
view channel
Gold Nanoparticles to Improve Accuracy of Ovarian Cancer Diagnosis
Ovarian cancer is considered one of the deadliest cancers, in part because it rarely shows clear symptoms in its early stages, and diagnosis is often complex. Current approaches make it difficult to accurately... Read more
Simultaneous Cell Isolation Technology Improves Cancer Diagnostic Accuracy
Accurate cancer diagnosis remains a challenge, as liquid biopsy techniques often fail to capture the complexity of tumor biology. Traditional systems for isolating circulating tumor cells (CTCs) vary in... Read more
Molecular Diagnostics
view channel
Brain Inflammation Biomarker Detects Alzheimer’s Years Before Symptoms Appear
Alzheimer’s disease affects millions globally, but patients are often diagnosed only after memory loss and other symptoms appear, when brain damage is already extensive. Detecting the disease much earlier... Read more
First-of-Its-Kind Blood Test Detects Over 50 Cancer Types
Many cancers lack routine screening, so patients are often diagnosed only after tumors grow and spread, when options are limited. A faster, less invasive approach that broadens early detection could shift... Read more
Routine Blood Draws Could Detect Epigenetic Biomarkers for Predicting Cardiovascular Disease Risk
Cardiovascular disease is a leading cause of death worldwide, yet predicting individual risk remains a persistent challenge. Traditional risk factors, while useful, do not fully capture biological changes... Read more
Hematology
view channel
Pioneering Model Measures Radiation Exposure in Blood for Precise Cancer Treatments
Scientists have long focused on protecting organs near tumors during radiotherapy, but blood — a vital, circulating tissue — has largely been excluded from dose calculations. Each blood cell passing through... Read more
Platelets Could Improve Early and Minimally Invasive Detection of Cancer
Platelets are widely recognized for their role in blood clotting and scab formation, but they also play a crucial role in immune defense by detecting pathogens and recruiting immune cells.... Read more
Portable and Disposable Device Obtains Platelet-Rich Plasma Without Complex Equipment
Platelet-rich plasma (PRP) plays a crucial role in regenerative medicine due to its ability to accelerate healing and repair tissue. However, obtaining PRP traditionally requires expensive centrifugation... Read more
Immunology
view channel
Companion Diagnostic Test Identifies HER2-Ultralow Breast Cancer and Biliary Tract Cancer Patients
Breast cancer is the most common cancer in Europe, with more than 564,000 new cases and 145,000 deaths annually. Metastatic breast cancer is rising in younger populations and remains the leading cause... Read more
Novel Multiplex Assay Supports Diagnosis of Autoimmune Vasculitis
Autoimmune vasculitis and related conditions are difficult to diagnose quickly and accurately, often requiring multiple tests to confirm the presence of specific autoantibodies. Traditional methods can... Read more
Blood Test Predicts Immunotherapy Efficacy in Triple-Negative Breast Cancer
Triple-negative breast cancer (TNBC) is an aggressive subtype lacking targeted therapies, making immunotherapy a promising yet unpredictable option. Current biomarkers such as PD-L1 expression or tumor... Read more
Simple Genetic Testing Could Predict Treatment Success in Multiple Sclerosis Patients
Multiple sclerosis (MS) patients starting therapy often face a choice between interferon beta and glatiramer acetate, two equally established and well-tolerated first-line treatments. Until now, the decision... Read moreMicrobiology
view channel
Microfluidic Platform Assesses Neutrophil Function in Sepsis Patients
Sepsis arises from infection and immune dysregulation, with neutrophils playing a central role in its progression. However, current clinical tools are unable to both isolate these cells and assess their... Read more
New Diagnostic Method Confirms Sepsis Infections Earlier
Sepsis remains one of the most dangerous medical emergencies, often progressing rapidly and becoming fatal without timely intervention. Each hour of delayed treatment in septic shock reduces patient survival... Read more
New Markers Could Predict Risk of Severe Chlamydia Infection
Chlamydia trachomatis is a common sexually transmitted infection that can cause pelvic inflammatory disease, infertility, and other reproductive complications when it spreads to the upper genital tract.... Read more
Portable Spectroscopy Rapidly and Noninvasively Detects Bacterial Species in Vaginal Fluid
Vaginal health depends on maintaining a balanced microbiome, particularly certain Lactobacillus species. Disruption of this balance, known as dysbiosis, can increase risks of infection, pregnancy complications,... Read moreTechnology
view channel
Coral-Inspired Capsule Samples Hidden Bacteria from Small Intestine
The gut microbiome has been linked to conditions ranging from immune disorders to mental health, yet conventional stool tests often fail to capture bacterial populations in the small intestine.... Read more
Rapid Diagnostic Technology Utilizes Breath Samples to Detect Lower Respiratory Tract Infections
Respiratory tract infections (LRTIs) are leading causes of illness and death worldwide, particularly among vulnerable populations such as the elderly, young children, and those with compromised immune systems.... Read more
Industry
view channel
Werfen and VolitionRx Partner to Advance Diagnostic Testing for Antiphospholipid Syndrome
Antiphospholipid syndrome (APS) is a rare autoimmune disorder that causes the immune system to produce abnormal antibodies, making the blood “stickier” than normal. This condition increases the risk of... Read more
