This article goes into both the pros and cons of the DNA test, and there are advantages on both sides. More than likely when it comes right down to brass tacks, who will pay for it, like everything else out there. If it is only $5.00 like it is in China, then no problem; however as one physician stated, some conditions cure themselves in a couple years and could lead to over treatment.
The DNA test is faster, hours instead of days, but more than likely the pap smear will be around for a number of years as DNA testing is still fairly new as well. BD
A new DNA test for the virus that causes cervical cancer does so much better than current methods that some gynecologists hope it will eventually replace the Pap smear in wealthy countries and cruder tests in poor ones.
Not only could the new test for human papillomavirus, or HPV, save lives; scientists say that women over 30 could drop annual Pap smears and instead have the DNA test just once every 3, 5 or even 10 years, depending on which expert is asked.
Their optimism is based on an eight-year study of 130,000 women in India financed by the Bill and Melinda Gates Foundation and published last week in The New England Journal of Medicine. It is the first to show that a single screening with the DNA test beats all other methods at preventing advanced cancer and death.
Significantly, none of the women who were negative on their DNA test died of cervical cancer. “So if you have a negative test, you’re good to go for several years,” Dr. Blumenthal said. Cervical cancer is caused by a few of the 150 strains of the human papillomavirus. Women pick strains up as soon as they start having intercourse, but more than 90 percent of cases clear up spontaneously within two years. Early DNA tests would find these, but lead to useless overtreatment.
Dr. Jan Agosti, the Gates Foundation officer overseeing its third world screening, said Qiagen’s new $5 test — which proved itself in a two-year study in China — runs on batteries without water or refrigeration, and takes less than three hours. In countries where women are “shyer about pelvic exams,” she added, it even works “acceptably well” on vaginal swabs they can take themselves.
This is excellent work sponsored by the Bill and Melinda Gates Foundation.
ReplyDeleteIf a woman has had cervical conization following a Class III-IV or Bethesda HSIL Pap test, colposcopy and biopsy, research shows that some strains of HPV may clear and other strains may remain.
Inquiring minds in the aforementioned situation need to know: Would the Gates Foundation DNA test be beneficial for us?
An Italian study, "Factors predicting human papillomavirus clearance in cervical intraepithelial neoplasia lesions treated by conization" (indexed on PubMed) indicates the Gates Foundation test may be useful as follow-up:
"[P]osttreatment follow-up should include both the PAP test and HPV detection techniques for early detection of any patients at increased risk for disease recurrence and progression, because of persistent oncogenic HPV types..
In the meantime, I'll stick to my annual ThinPrep.
BTW, the ThinPrep sample collected for the Pap can also be used (in conjunction with other lab tests) to test for HPV DNA, Chlamydia, and Gonorrhea.
Disclaimer: I have no financial or other interest in ThinPrep, its manufacturers, distributors, physician or cytologist users, other than staying healthy.