HPV Testing Could Be Used as Primary Screen for Cervical Cancer, Study Concludes
Testing for human papillomavirus (HPV) could be used as a primary screening tool for cervical cancer in women older than age 30, with a traditional Pap test used as a follow-up test for women who test positive for the virus, concluded the authors of a large study in the United Kingdom.
The HART (HPV in Addition to Routine Testing) study, led by Jack Cuzick, Ph.D., and colleagues from Cancer Research U.K., included about 11,000 women ages 30 to 60 in five regions throughout the United Kingdom who participated in the study between 1998 and 2001. All women received cytology and an HPV test. Women with borderline cytology and women positive for high-risk HPV with negative cytology were randomly assigned to immediate colposcopy or to surveillance by repeat HPV testing, cytology, and colposcopy at 12 months.
HPV testing was more sensitive than borderline or worse cytology (97% compared with 77%) but slightly less specific (93% compared with 96%) for detecting malignant cells. Surveillance at 12 months was as effective as immediate colposcopy for women with either borderline cytology results (regardless of HPV status) or who were HPV-positive but had negative cytology results.
The study was published in the December 6 issue of The Lancet.
See also News, Vol. 95, No. 6, p. 424, "Guidelines Recommend Less Frequent Screening Interval for Cervical Cancer," and Vol. 93, No. 4, p. 259, "Study Results Help Define HPVs Role as Diagnostic Tool."
Potassium Iodide Should Be Publicly Available, Report Concludes
Potassium iodide pills should be available to everyone age 40 or youngerespecially children and pregnant and lactating womenwho live near a nuclear power plant, according to a new report from the National Academies National Research Council.
Potassium iodide can prevent thyroid cancer caused by exposure to radioactive iodine, a compound that could be released during a severe accident at a nuclear power plant. Potassium iodide will not protect the body against other types of radioactive isotopes released during nuclear-reactor incidents or those likely to be used in a so-called dirty bomb, added the committee that wrote the report.
For potassium iodide to be most effective, it must be taken within a few hours before or after exposure to radioactive iodine, the report said. Further protection from risk should be accomplished by evacuation and by control of contaminated milk and food.
The study was mandated by Congress and sponsored by the U.S. Centers for Disease Control and Prevention.
See also News, Vol. 94, No. 2, p. 86, "Congress Considers Stockpiling Potassium Iodide."
Virtual Colonoscopy as Accurate as Traditional Screening Test, Study Finds
Virtual colonoscopy, or a computer-generated reconstruction of the colon based on images from a CT scan, finds the same number of polyps in the colon as the conventional, invasive type of colonoscopy, a new study has found.
Previous studies of virtual colonoscopy yielded mixed results when compared with conventional testing. Earlier versions of this technology used two-dimensional images of the colon to look for polyps. In this recent study, Perry J. Pickhardt, M.D., of the University of Wisconsin Medical School, and colleagues used three-dimensional "fly-through" images, allowing radiologists to see detailed images of the interior of the colon.
For the study, 1233 patients with no symptoms of colon cancer underwent same-day virtual and conventional colonoscopy. The sensitivity of virtual colonoscopy was 93.8% for polyps at least 10 mm in diameter, 93.9% for polyps at least 8 mm in diameter, and 88.7% for polyps at least 6 mm in diameter. By comparison, the sensitivity of conventional colonoscopy was 87.5%, 91.5%, and 92.3% for the three sizes of polyps, respectively.
"If the results of this well-designed study are reproducible on a wider scale, and if the important questions regarding the appropriate size threshold and the surveillance of smaller polyps can be resolved, then screening virtual colonoscopy is ready for prime time," wrote editorialists Martina M. Morrin, M.B., and Thomas LaMont, M.D.
The study was published in the December 4 issue of the New England Journal of Medicine.
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