HPV Testing Post-CIN Treatment Found Cost Effective

Second study shows continuing excess risk of cervical cancer after CIN despite post-treatment follow-up

TUESDAY, Nov. 6 (HealthDay News) -- Women with a history of cervical intraepithelial neoplasia (CIN) can be screened more cheaply and effectively post-treatment by testing for human papillomavirus (HPV), while women with CIN who complete post-treatment follow-up still have an increased risk of cervical cancer, according to two studies published online Nov. 1 in BMJ.

In the first study, Rosa Legood, D.Phil., from the London School of Hygiene and Tropical Medicine, and colleagues analyzed the cost-effectiveness of HPV testing after treatment for CIN. The researchers found that cytological follow-up alone would result in 29 cases of recurrent stage 3 CIN over 10 years and would cost £358,222 ($574,910) per 1,000 women treated. Adding HPV testing for test of cure in women who were cytologically negative would avert 8.4 additional cases and reduce costs by £9,388 per 1,000 women treated.

In the second study, Matejka Rebolj, Ph.D., from the Erasmus Medical Center in Rotterdam, Netherlands, and colleagues compared 10-year cervical cancer risk in 38,956 women with grade 1 to 3 CIN who returned to routine screening after completing post-treatment follow-up (three smear tests at six, 12, and 24 months) and 7,096,816 women whose primary smear tests were normal. The researchers found a higher risk of cervical cancer in women with a history of CIN (35.1 versus 6.4 per 100,000 woman-years; adjusted hazard ratio, 4.2).

"An excess risk of cervical cancer previously observed for women treated for cervical intraepithelial neoplasia was also observed in the subgroup of women who completed their post-treatment follow-up with three consecutive normal smear test results," Rebolj and colleagues write.

One author in the Legood study is involved in configuring a new trial of cervical screening which will involve support from manufacturers. Several authors from the Rebolj study and the editorial authors disclosed financial ties to the pharmaceutical and biotechnology industries.

Full Text - Legood
Full Text - Rebolj
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