Skip to main content
SpringerLink
Log in

Human Papillomavirus DNA Testing for Cervical Cancer Screening

Practical Aspects in Developing Countries

  • Review Article
  • Published:
Molecular Diagnosis & Therapy Aims and scope Submit manuscript

Abstract

Cervical cancer is the second most common cancer in women worldwide, and the most common cause of death from cancer in women in the developing world. Cervical cancer represents the only gynecologic cancer that can be prevented through regular screening. Although there are established screening programs in the Western world that have effectively reduced the burden of cervical cancer, these programs have relied on insensitive screening technologies that depend on the long preinvasive phase of cervical carcinogenesis. The developing world faces specific additional challenges in implementing a successful cervical cancer screeing program.

The association between cervical cancers and human papillomavirus (HPV) make testing for the presence of HPV DNA a valuable screening tool. This review focuses on practical aspects of the implementation and delivery of HPV testing as the primary cervical cancer screening strategy in the developing world, and attempts to offer some solutions to the real-world challenges faced in these regions.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Notes

  1. Unless a specified assay is cited, our comments relate to testing with Hybrid Capture technology.

References

  1. Parkin DM, Bray F, Ferlay J, et al. Global cancer statistics, 2002. CA Cancer J Clin 2005; 55: 74–108

    Article  PubMed  Google Scholar 

  2. Sankaranarayanan R, Wesley R, Somanathan T, et al. Visual inspection of the uterine cervix after the application of acetic acid in the detection of cervical carcinoma and its precursors. Cancer 1998; 83: 2150–6

    Article  PubMed  CAS  Google Scholar 

  3. Walboomers JM, Jacobs MV, Manos MM, et al. Human papillomavirus is a necessary cause ofinvasive cervical cancer worldwide. J Pathol 1999; 189:12–9

    Article  PubMed  CAS  Google Scholar 

  4. Laara E, Day NE, Hakama M. Trends in mortality from cervical cancer in the Nordic countries: association with organised screening programmes. Lancet 1987; 1: 1247–9

    Article  PubMed  CAS  Google Scholar 

  5. Altekruse SF, Kosary CL, Krapcho M, et al., editors. SEER cancer statistics review 1975–2007. Bethesda (MD): National Cancer Institute, 2010 Jun 30 [online]. Available from URL: http://seer.cancer.gov/csr/1975_2007/index.html [Accessed 2010 Aug 3]

  6. Papanicolaou GN, Traut HF. The diagnostic value of vaginal smears in carcinoma of the uterus. Am J Obstet Gynecol 1941; 42: 193–206

    Google Scholar 

  7. Cuzick J, Clavel C, Petry KU, et al. Overview of the European and North American studies on HPV testing in primary cervical cancer screening. Int J Cancer 2006; 119: 1095–101

    Article  PubMed  CAS  Google Scholar 

  8. Sankaranarayanan R, Esmy PO, Rajkumar R, et al. Effect of visual screening on cervical cancer incidence and mortality in Tamil Nadu, India: a cluster-randomised trial. Lancet 2007; 370: 398–406

    Article  PubMed  Google Scholar 

  9. Sankaranarayanan R, Nene BM, Shastri SS, et al. HPV screening for cervical cancer in rural India. N Engl J Med 2009; 360: 1385–94

    Article  PubMed  CAS  Google Scholar 

  10. zur Hausen H. Natural history and carcinogenesis of cervical cancer: the global picture [keynote lecture]. 2010 Annual Meeting, European Research Organisation on Genital Infection and Neoplasia (EUROGIN); 2010 Feb 17–20; Monte Carlo

  11. Clifford GM, Smith JS, Plummer M, et al. Human papillomavirus types in invasive cervical cancer worldwide: a meta-analysis. Br J Cancer 2003; 88: 63–73

    Article  PubMed  CAS  Google Scholar 

  12. Clifford GM, Smith JS, Aguado T, et al. Comparison of HPV type distribution in high-grade cervical lesions and cervical cancer: a meta-analysis. Br J Cancer 2003; 89: 101–5

    Article  PubMed  CAS  Google Scholar 

  13. Clifford GM, Rana RK, Franceschi S, et al. Human papillomavirus genotype distribution in low-grade cervical lesions: comparison by geographic region and with cervical cancer. Cancer Epidemiol Biomarkers Prev 2005; 14: 1157–64

    Article  PubMed  Google Scholar 

  14. Kulasingam SL, Myers ER. Potential health and economic impact of adding a human papillomavirus vaccine to screening programs. JAMA 2003; 290: 781–9

    Article  PubMed  Google Scholar 

  15. Belinson JL, Hu S, Niyazi M, et al. Prevalence of type-specific human papillomavirus in endocervical, upper and lower vaginal, perineal and vaginal self-collected specimens: implications for vaginal self-collection. Int J Cancer 2010; 127: 1151–7

    Article  PubMed  CAS  Google Scholar 

  16. Belinson J, Qiao YL, Pretorius R, et al. Shanxi Province Cervical Cancer Screening Study: a cross-sectional comparative trial of multiple techniques to detect cervical neoplasia. Gynecol Oncol 2001; 83: 439–44

    Article  PubMed  CAS  Google Scholar 

  17. Belinson JL, Qiao YL, Pretorius RG, et al. Shanxi Province Cervical Cancer Screening Study II: self-sampling for high-risk human papillomavirus compared to direct sampling for human papillomavirus and liquid based cervical cytology. Int J Gynecol Cancer 2003; 13: 819–26

    Article  PubMed  CAS  Google Scholar 

  18. Belinson JL, Hui D, Wang GP, et al. Evaluation of the POI/NIH cervico-vaginal self-sampler for HPV from the SHENCCAST II trial [abstract]. 4th Biennial Meeting, Asia Oceania Research Organisation on Genital Infections and Neoplasia (AOGIN); 2010 Mar 26–28; New Delhi

  19. Tisci S, Shen YH, Fife D, et al. Patient acceptance of self-sampling for human papillomavirus in rural China. J Low Genit Tract Dis 2003; 7: 107–16

    Article  PubMed  CAS  Google Scholar 

  20. Nieves-Arriba L, Enerson C, Belinson S, et al. Mexican Cervical Cancer Screening Study II: acceptability of a new self-sampling device [abstract no. 43]. 41st Annual Meeting, Society Of Gynecologic Oncologists; 2010 Mar 14–17; San Francisco (CA)

  21. Naucler P, Ryd W, Tornberg S, et al. Human papillomavirus and Papanicolaou tests to screen for cervical cancer. N Engl J Med 2007; 357: 1589–97

    Article  PubMed  CAS  Google Scholar 

  22. Mayrand MH, Duarte-Franco E, Rodrigues I, et al. Human papillomavirus DNA versus Papanicolaou screening tests for cervical cancer. N Engl J Med 2007; 357: 1579–88

    Article  PubMed  CAS  Google Scholar 

  23. Cuzick J, Szarewski A, Mesher D, et al. Long-term follow-up of cervical abnormalities among women screened by HPV testing and cytology: results from the Hammersmith Study. Int J Cancer 2008; 122: 2294–300

    Article  PubMed  CAS  Google Scholar 

  24. Shi JF, Belinson JL, Zhao FH, et al. Human papillomavirus testing for cervical cancer screening: results from a 6-year prospective study in rural China. Am J Epidemiol 2009; 170: 708–16

    Article  PubMed  Google Scholar 

  25. Dillner J, Rebolj M, Birembaut P, et al. Long term predictive values of cytology and human papillomavirus testing in cervical cancer screening: joint European cohort study. BMJ 2008; 337: a1754

    Article  PubMed  Google Scholar 

  26. Franceschi S, Herrero R, Clifford GM, et al. Variations in the age-specific curves of human papillomavirus prevalence in women worldwide. Int J Cancer 2006; 119: 2677–84

    Article  PubMed  CAS  Google Scholar 

  27. Qiao YL, Sellors JW, Eder PS, et al. A new HPV-DNA test for cervical-cancer screening in developing regions: a cross-sectional study of clinical accuracy in rural China. Lancet Oncol 2008; 9: 929–36

    Article  PubMed  Google Scholar 

  28. Söderlund-Strand A, Dillner J, Carlson J. High-throughput genotyping of oncogenic human papilloma viruses with MALDI-TOF mass spectrometry. Clin Chem 2008; 54(1): 86–92

    Article  PubMed  Google Scholar 

  29. Chirenje ZM, Rusakaniko S, Akino V, et al. A randomised clinical trial of loop electrosurgical excision procedure (LEEP) versus cryotherapy in the treatment of cervical intraepithelial neoplasia. J Obstet Gynaecol 2001; 21: 617–21

    Article  PubMed  CAS  Google Scholar 

  30. Chamot E, Kristensen S, Stringer JS, et al. Are treatments for cervical pre-cancerous lesions in less-developed countries safe enough to promote scaling-up of cervical screening programs? A systematic review. BMC Womens Health 2010; 10: 11

    Article  PubMed  Google Scholar 

  31. Mitchell MF, Tortolero-Luna G, Cook E, et al. A randomized clinical trial of cryotherapy, laser vaporization, and loop electrosurgical excision for treatment of squamous intraepithelial lesions of the cervix. Obstet Gynecol 1998; 92: 737–44

    Article  PubMed  CAS  Google Scholar 

  32. Martin-Hirsch PP, Paraskevaidis E, Bryant A, et al. Surgery for cervical intraepithelial neoplasia. Cochrane Database Syst Rev 2010; (6): CD001318

  33. Wulan N, Rasool N, Belinson SE, et al. Study of the diagnostic efficacy of realtime optical coherence tomography as an adjunct to unaided visual inspection with acetic acid for the diagnosis of preinvasive and invasive neoplasia of the uterine cervix. Int J Gynecol Cancer 2010; 20: 422–7

    Article  PubMed  Google Scholar 

  34. Belinson JL, Pretorius RG, Enerson C, et al. The Mexican Cervical Cancer Screening Trial: self-sampling for human papillomavirus with unaided visual inspection as a secondary screen. Int J Gynecol Cancer 2009; 19: 27–32

    Article  PubMed  Google Scholar 

  35. Day SP, Hudson A, Mast A, et al. Analytical performance of the investigational use only Cervista HPV HR test as determined by a multi-center study. J Clin Virol 2009; 45Suppl. 1: S63–72

    Article  PubMed  CAS  Google Scholar 

  36. Thai H, Rangwala S, Gay T, et al. An HPV 16,18, and 45 genotyping test based on Hybrid Capture technology. J Clin Virol 2009; 45Suppl. 1: S93–7

    Article  PubMed  CAS  Google Scholar 

  37. Kraus I, Molden T, Holm R, et al. Presence of E6 and E7 mRNA from human papillomavirus types 16, 18, 31, 33, and 45 in the majority of cervical carcinomas. J Clin Microbiol 2006; 44: 1310–7

    Article  PubMed  CAS  Google Scholar 

  38. Global Polio Eradication Initiative. The history [online]. Available from URL: http://www.polioeradication.org/history.asp [Accessed 2010 Jul 27]

Download references

Acknowledgments

Drs. Suzanne and Jerome Belinson have previously received research funding from Hologic, Inc., Qiagen (Digene), Gen-Probe, Inc., and Imalux Corp. Dr. Suzanne Belinson is currently employed by the Blue Cross Blue Shield Association.

Author information

Authors and Affiliations

  1. Preventive Oncology International, Inc., 2762 Fairmount Blvd., Cleveland Heights, Ohio, 44118, USA

    Suzanne E. Belinson & Jerome L. Belinson

Authors
  1. Suzanne E. Belinson
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jerome L. Belinson
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Suzanne E. Belinson.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Belinson, S.E., Belinson, J.L. Human Papillomavirus DNA Testing for Cervical Cancer Screening. Mol Diag Ther 14, 215–222 (2010). https://doi.org/10.1007/BF03256376

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF03256376

Keywords

Search

Navigation