New human papillomavirus research has been reported by scientists at National Institutes of Health
2009 AUG 3 - (NewsRx.com) -- In this recently published article, scientists in the United States conducted a study "To estimate efficacy of a visual triage of human papillomavirus (HPV)-positive women to either immediate cryotherapy or referral if not treatable (eg, invasive cancer, large precancers). We evaluated visual triage in the HPV-positive women aged 25 to 55 years from the 10,000-woman Guanacaste Cohort Study (n = 552)." "Twelve Peruvian midwives and 5 international gynecologists assessed treatability by cryotherapy using digitized high-resolution cervical images taken at enrollment. The reference standard of treatability was determined by 2 lead gynecologists from the entire 7-year follow-up of the women. Women diagnosed with histologic cervical intraepithelial neoplasia grade 2 or worse or 5-year persistence of carcinogenic HPV infection were defined as needing treatment. Midwives and gynecologists judged 30.8% and 41.2% of women not treatable by cryotherapy, respectively (P < 0.01). Among 149 women needing treatment, midwives and gynecologists correctly identified 57.5% and 63.8% (P = 0.07 for difference) of 71 women judged not treatable by the lead gynecologists and 77.6% and 59.7% (P < 0.01 for difference) of 78 women judged treatable by cryotherapy. The proportion of women judged not treatable by a reviewer varied widely and ranged from 18.6% to 61.1%. Interrater agreement was poor with mean pairwise overall agreement of 71.4% and 66.3% and kappa's of 0.33 and 0.30 for midwives and gynecologists, respectively. In future ''screen-and-treat'' cervical cancer prevention programs using HPV testing and cryotherapy, practitioners will visually triage HPV-positive women. The suboptimal performance of visual triage suggests that screen-and-treat programs using cryotherapy might be insufficient for treating precancerous lesions," wrote J.C. Gage and colleagues, National Institutes of Health. The researchers concluded: "Improved, low-technology triage methods and/or improved safe and low-technology treatment options are needed.." Gage and colleagues published their study in International Journal of Gynecological Cancer (An Evaluation by Midwives and Gynecologists of Treatability of Cervical Lesions by Cryotherapy Among Human Papillomavirus-Positive Women. International Journal of Gynecological Cancer, 2009;19(4):728-733). For more information, contact J.C. Gage, National Cancer Institute, Hormonal & Reproductive Epidemiology Branch, DCEG, National Institutes of Health, 6120 Executive Blvd., EPS, Room 5034B, Bethesda, MD 20892, USA. Publisher contact information for the International Journal of Gynecological Cancer is: Lippincott Williams & Wilkins, 530 Walnut St., Philadelphia, PA 19106-3621, USA. Keywords: United States, Bethesda, Cancer, Cervical Intraepithelial Neoplasia, Clinical Trial Research, Cryotherapy, Gynecology, HPV, Human Papillomavirus, Medical Device, Oncology, National Institutes of Health. This article was prepared by Biotech Business Week editors from staff and other reports. Copyright 2009, Biotech Business Week via NewsRx.com.
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