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
 (3) (1).png)
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
Respiratory Syncytial Virus Test
OSOM® RSV Test
Pipette
Accumax Smart Series
Gold Member
Collection and Transport System
PurSafe Plus®
Latest Molecular Diagnostics News
- Blood Test Combined with MRI Brain Scans Reveals Two Distinct Multiple Sclerosis Types
- At-Home Blood Tests Accurately Detect Key Alzheimer's Biomarkers
- Ultra-Sensitive Blood Biomarkers Enable Population-Scale Insights into Alzheimer’s Pathology
- Blood Test Could Predict Death Risk in World’s Most Common Inherited Heart Disease
- Rapid POC Hepatitis C Test Provides Results Within One Hour
- New Biomarkers Predict Disease Severity in Children with RSV Bronchiolitis
- CTC Measurement Blood Test Guides Treatment Decisions in Metastatic Breast Cancer Subtype
- Multiplex Antibody Assay Could Transform Hepatitis B Immunity Testing
- Genetic Testing Improves Comprehensive Risk-Based Screening for Breast Cancer
- Urine Test Could Reveal Real Age and Life Span
- Genomic Test Identifies African Americans at Risk for Early Prostate Cancer Recurrence
- Blood Test Could Identify Biomarker Signature of Cerebral Malaria
- World’s First Biomarker Blood Test to Assess MS Progression
- Neuron-Derived Extracellular Vesicles Could Improve Alzheimer’s Diagnosis
- Sample Prep Instrument to Empower Decentralized PCR Testing for Tuberculosis
- Endometriosis Blood Test Could Replace Invasive Laparoscopic Diagnosis
Channels
Clinical Chemistry
view channel
Blood Test Could Predict and Identify Early Relapses in Myeloma Patients
Multiple myeloma is an incurable cancer of the bone marrow, and while many patients now live for more than a decade after diagnosis, a significant proportion relapse much earlier with poor outcomes.... Read more
Compact Raman Imaging System Detects Subtle Tumor Signals
Accurate cancer diagnosis often depends on labor-intensive tissue staining and expert pathological review, which can delay results and limit access to rapid screening. These conventional methods also make... Read more
Molecular Diagnostics
view channel
At-Home Blood Tests Accurately Detect Key Alzheimer's Biomarkers
Diagnosing Alzheimer’s disease typically relies on brain scans or spinal fluid tests, which are invasive, costly, and difficult to access outside specialist clinics. These barriers have limited large-scale... Read more
Blood Test Combined with MRI Brain Scans Reveals Two Distinct Multiple Sclerosis Types
Multiple sclerosis (MS) affects more than 2.8 million people worldwide, yet predicting how the disease will progress in individual patients remains difficult. Current MS classifications are based on clinical... Read more
Ultra-Sensitive Blood Biomarkers Enable Population-Scale Insights into Alzheimer’s Pathology
Accurately estimating how many people carry Alzheimer’s disease pathology has long been a challenge, as traditional methods rely on small, clinic-based samples rather than the general population.... Read more
Blood Test Could Predict Death Risk in World’s Most Common Inherited Heart Disease
Hypertrophic cardiomyopathy (HCM) is the world’s most common inherited heart condition and affects millions of people globally. While some patients live with few or no symptoms, others develop heart failure,... Read moreHematology
view channel
MRD Tests Could Predict Survival in Leukemia Patients
Acute myeloid leukemia is an aggressive blood cancer that disrupts normal blood cell production and often relapses even after intensive treatment. Clinicians currently lack early, reliable markers to predict... Read more
Platelet Activity Blood Test in Middle Age Could Identify Early Alzheimer’s Risk
Early detection of Alzheimer’s disease remains one of the biggest unmet needs in neurology, particularly because the biological changes underlying the disorder begin decades before memory symptoms appear.... Read more
Microvesicles Measurement Could Detect Vascular Injury in Sickle Cell Disease Patients
Assessing disease severity in sickle cell disease (SCD) remains challenging, especially when trying to predict hemolysis, vascular injury, and risk of complications such as vaso-occlusive crises.... Read more
ADLM’s New Coagulation Testing Guidance to Improve Care for Patients on Blood Thinners
Direct oral anticoagulants (DOACs) are one of the most common types of blood thinners. Patients take them to prevent a host of complications that could arise from blood clotting, including stroke, deep... Read moreImmunology
view channel
Ultrasensitive Liquid Biopsy Demonstrates Efficacy in Predicting Immunotherapy Response
Immunotherapy has transformed cancer treatment, but only a small proportion of patients experience lasting benefit, with response rates often remaining between 10% and 20%. Clinicians currently lack reliable... Read more
Blood Test Could Identify Colon Cancer Patients to Benefit from NSAIDs
Colon cancer remains a major cause of cancer-related illness, with many patients facing relapse even after surgery and chemotherapy. Up to 40% of people with stage III disease experience recurrence, highlighting... Read more
Microbiology
view channel
New UTI Diagnosis Method Delivers Antibiotic Resistance Results 24 Hours Earlier
Urinary tract infections affect around 152 million people every year, making them one of the most common bacterial infections worldwide. In routine medical practice, diagnosis often relies on rapid urine... Read more
Breakthroughs in Microbial Analysis to Enhance Disease Prediction
Microorganisms shape human health, ecosystems, and the planet’s climate, yet identifying them and understanding how they are related remains a major scientific challenge. Even with modern DNA sequencing,... Read more
Technology
view channel
Pioneering Blood Test Detects Lung Cancer Using Infrared Imaging
Detecting cancer early and tracking how it responds to treatment remains a major challenge, particularly when cancer cells are present in extremely low numbers in the bloodstream. Circulating tumor cells... Read more
AI Predicts Colorectal Cancer Survival Using Clinical and Molecular Features
Colorectal cancer is one of the most common and deadly cancers worldwide, and accurately predicting patient survival remains a major clinical challenge. Traditional prognostic tools often rely on either... Read more
Industry
view channel
BD and Penn Institute Collaborate to Advance Immunotherapy through Flow Cytometry
BD (Becton, Dickinson and Company, Franklin Lakes, NJ, USA) has entered into a strategic collaboration with the Institute for Immunology and Immune Health (I3H, Philadelphia, PA, USA) at the University... Read more
