How Can Clinical Labs Support Comprehensive Cervical Cancer Screening?
Pap and HPV testing together is highly sensitive and offers the most comprehensive defense against rising rates of cervical cancer
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How have innovations in cervical cancer screening changed disease rates and trends?
Historically, cervical cancer screening has made a huge impact in reducing incidence and mortality rates: Cervical cancer was once the number one cause of cancer death in women. Since introducing the Pap test, mortality rates declined by 70%. The subsequent introduction of liquid-based cytology and HPV testing further improved the detection of precancerous lesions. Despite these successes, fewer women are up-to-date with screening leading to a rise in cervical cancer, particularly in younger women. A similar trend toward increased incidence of late-stage cancers further highlights the importance of regular screening for the prevention and early detection of cervical cancer.
What are the advantages and disadvantages of current approaches to cervical cancer screening?
Current US screening guidelines for cervical cancer include three different modalities:
- 21–65 years of age: Pap test every three years
- 30–65 years: HPV test every five years
- 30–65 years: Pap test and HPV test together (co-testing) every five years
For women ages 21-29, Pap testing is critical to detect precancerous lesions and prevent disease progression. Starting at age 30, co-testing is the most sensitive strategy for detecting cervical cancer and precancer. According to one of the largest US retrospective studies of cervical cancer screening strategies, co-testing detected 95 percent of cancers and 99.7 percent of precancerous lesions, while HPV testing alone missed 22.5 percent of cancers.
What impact do screening guidelines have on patients and reimbursement?
Screening guidelines determine access, and in turn, influence the prevention and treatment of cervical cancer. Multiple organizations, including the U.S. Preventive Services Task Force (USPSTF), issue cervical cancer screening guidelines to help inform and guide physicians and patients. It's important for current screening methods—such as co-testing—to maintain an A or B rating within the USPSTF guidelines. As a result, preventive services are typically covered at no cost to patients under the Affordable Care Act.
How can clinical labs ensure the most comprehensive screening options remain available to patients?
As a clinical lab professional, you can do the following:
- Stay up to date with available data.
- Comment on draft guidelines to protect choice in screening methods.
- Make your voice heard within your professional society to maintain these testing options.
Clinical labs may further improve disease detection and screening efficiency with future screening innovations, such as imaging systems and artificial intelligence. New technology and continued advocacy for up-to-date screenings will be important in the fight against cervical cancer.
