New HPV Self-Test Kits: Better Detection and Less Cervical Cancer

 Oct 21, 2011 A new self-test for HPV, the greatest cause of cervical cancer, enables women to test themselves easily, at home. Better diagnosis, less cervical cancer. According to the World Health Organization, cervical cancer is the second most common cancer in women and virtually all cases are linked to certain strains of human papillomavirus, or HPV. Each year, at least a half million new cases of HPV emerge and over a quarter million deaths can be attributed to it. In many places, however, women do not have access to medical facilities for screening and are not regularly screened for persistent HPV infections, long identified as the most common cause of cervical cancer.

The HPV-Cervical Cancer Link  A team of researchers investigated a self-testing method for HPV and published their study in the October 2011 issue of Journal of Clinical Microbiology. The first author, Yvonne Delere, of the Robert Koch Institute of the Ministry of Health in Berlin wrote, "The high sensitivity of this self-sampling method guarantees to identify nearly all HPV-infected women." Researchers in the Netherlands, led by Professor Chris Meijer from the VU University Medical Centre, investigated whether home-testing kits would improve HPV detection rates and published the results in the British Medical Journal in March 2011. Results of both studies showed that enabling women to test themselves for HPV at home would result in higher rates of HPV detection, leading to earlier treatment, translating into a dramatic reduction in the number of deaths from cervical cancer.

Persistence of HPV Infection a Causal Factor According to long-existing research, some strains of HPV are found in most cases of cervical cancer. Furthermore, only persistently detectable HPV infections seem to be associated with cervical cancer risk. Kevin A. Ault, MD, of the Department of Gynecology and Obstetrics at Emory University School of Medicine writes in an editorial that, "persistent HPV infection is an intermediate step in the development of cervical cancer." Another researcher, Hui-Chi Chen, PhD, of the Genomics Research Center of Academia Sinica in Taipei, Taiwan adds that it is, "the duration of infection, rather than a one-time infection, that predicts cervical cancer risk," indicating a need to, "repeat HPV testing more frequently than every two years for HPV-positive women." Taken together, these findings show that repeated testing to detect HPV as early as possible, would mean the difference between life and death for the quarter million women who die from cervical cancer each year.

The Delphi Screener In a Dutch cervical screening program, PROHTECT, researchers identified a large group of women—over 28,000—who they invited to use a self-testing kit including a highly-sensitive device called a Delphi Screener, designed for the detection of HPV. The authors of the study, published in the British Medical Journal, concluded that the use of the home self-sampling kit for HPV, "would lead to twice as many cases of cervical cancer being diagnosed compared with the regular screening program." Furthermore, the women who used the Delphi Screener were also asked to rate the device for its ease of use and gave it an average rating of 12 on a scale of 0 (easy) to 100 (difficult).

 How the Delphi Screener Works The home self-sampling kit used in the Dutch studies, includes the Delphi Screener, which is a sterile, syringe-like device containing five milliliters of buffered saline solution. The user operates the device by inserting the syringe-like device into the vagina, then plunging the handle. This releases a saline solution into the vagina where it is held for five seconds. She then releases the handle and the device retrieves the fluid. She removes the device and deposits the retrieved fluid into a pre-labeled, coded tube by depressing the plunger. The final step is to mail the tube to the laboratory for testing.