Cervical cancer - HPV molecular screening is the most effective method of prevention

Several European studies conclude that the HPV (Human Papilloma Virus) screening test should be performed, instead of a conventional cytology, as an initial screening technique. These studies estimate that approximately 30% of cases of cervical cancer in women between 25 and 64 years of age can be avoided when molecular screening for HPV is used as the initial screening technique.

Related Tags

  • Gynaecology
  • oncology

One of the most common sexually transmitted infections in the world is HPV. It is usually acquired sexually, by vertical transmission (from mother to child, during childbirth) and horizontal transmission (from child to child, in childhood).

About 15% of all sexually active women contract the infection, and this percentage decreases as they age. The prevalence of HPV infection in young women who have already started sexual activity varies between 40 and 80%, with a lifetime probability of being infecting ranging from of 80 to 90%. In most situations the HPV infection is resolved spontaneously, without clinical symptoms and without persistence of the virus. When, on the contrary, the virus persists for periods longer than two years, the risk of developing cervical cancer becomes very high.

Although the infection can be asymptomatic, the clinical manifestation and its severity depend on the genotype of the virus that causes the infection. There are over 200 different genotypes, of which about 40 can be isolated from samples from the anal and genital region. Among them there are 14 high oncogenic risk genotypes, which are responsible for approximately 70% of cervical cancer cases.

The HPV detection, and its genotyping, is highly sensitive and specific. Primary laboratory screening can be carried out by searching for HPV 16, 18, and other non-discriminated subtypes of high oncogenic risk. For a more refined risk assessment and therapeutic guidance, the laboratory can also perform complete HPV genotyping. In the latter case, all high-risk and likely high-risk subtypes are broken down individually, and low-risk subtypes with high prevalence in humans are also identified. It is very common to have infections with more than one subtype of HPV.

The Laboratório Dr. Joaquim Chaves provides several Human Papillomavirus research techniques, including the Cobas 8800 test for screening and complete genotyping for detection of low-risk, likely-risk and high-risk genotypes. The sample of choice is a cervico-vaginal sample and the results are made available after a week, at most. There is also the possibility of, in the same screening, differentiating the two most oncogenic subtypes, 16 and 18, at no additional cost. The Laboratory has a high level of experience in molecular research on HPV, with around 10,000 screening tests per year, and around 5,000 of complete genotyping. It can also complement the clinical decision algorithm through conventional exams in Pathological Anatomy, cytology and histology.

Gynecology is the central medical specialty involved, but with new presentations of neoplasms caused by HPV, the involvement of Urology, Dermatology, Pneumology and Otorhinolaryngology assume greater relevance. You can schedule an appointment for these medical specialties at one of our clinics.

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