Please could you give a brief introduction to the human papillomavirus (HPV)?
Human papillomavirus is a virus that is transmitted through sexual contact. In most cases the virus is transient and causes no harm, however in some cases it can go on to cause pre-cancer lesions and cervical cancer.
Your recent research assessed the cost effectiveness of HPV test of cure after treatment for cervical intraepithelial neoplasia (CIN). Please could you explain what CIN are?
CIN are pre-cancer lesions that occur before the development of cancer. They can be treated effectively to prevent cancer.
What exactly is a HPV test of cure?
By testing women for HPV after they have been treated for pre-cancer lesions we can check whether they are safe to return to routine screening or need to be followed up longer term.
How does a HPV test of cure differ from cervical screening (cytology testing)?
With HPV the sample is taken in the same way but it is processed differently in the laboratory. With cytology a slide is made that is read under the microscope, with HPV testing the sample is tested to see whether or not high risk strains of the HPV virus are present.
What did you recent research involve?
A study was conducted at Six Sentinel laboratories in England where women that had been treated for pre-cancer lesions were HPV tested. We used these data and compared it with routine data to model the longer term costs and effects over 10 years of different management strategies.
What did your study find?
We found that it is was more effective to use HPV testing in the management of women following CIN treatment than having annual cytology testing which was the current practice at the time of the study. We also predicted that over a ten year time span HPV test of cure also saved money compared to annual cytology testing.
What impact do you think your research will have?
The NHS cancer screening programme have now changed the guidelines and HPV test of cure is now the recommended practice.
Where can readers find more information?
They can read our research paper here: http://www.bmj.com/content/345/bmj.e7086
They can find more information here: http://www.cancerscreening.nhs.uk/cervical/hpv-test-of-cure.html
About Dr Rosa Legood
Rosa joined London School of Hygiene and Tropical Medicine as a lecturer in 2007. Her training is in health economics and public health.
Previously she worked at Oxford in the Department of Public Health and York Health Economics Consortium.
She has specific expertise in modelling the cost-effectiveness of screening technologies and vaccination options.