Several weeks ago, the ACIP (Advisory Committee on Immunization Practice) finally changed their position on the HPV vaccine use for boys and young men from allowed to recommended. This after delaying for six years after having recommended the vaccine for girls and young women.
Despite the research which has been conducted regarding the HPV test itself and using it in conjunction with cytology (Pap testing), the FDA continues to restrict its use to women thirty and older.
The Roche cobas test is the only U.S.- and globally-approved test for 14 high risk strains of HPV as well as for the genotype of the two most aggressive strains (16 and 18). Strains 16 and 18 are responsible for 70 percent of cervical cancer occurance. Data taken from the ATHENA study (stands for Addressing The Need for Advanced HPV Diagnostics) used to assess the cobas test accuracy indicate that cervical cancer was identified at a higher rate than with cervical cytology (Pap) testing alone in primary screening.
The Netherlands is one of the first countries in Europe to begin utilizing the cobas test as its primary screening tool. The United States however continues to lag behind when it comes to incorporating cobas into primary screening and continues to restrict it to women 30 and over.
While the newly proposed screening guidelines for the United States are being finalized subsequent to open comment by the public which ended last month, that portion of the guidelines continues to remain "up in the air" as it has for years, continuing to claim they are in need of more information before making any final conclusions.
Obviously the Netherlands found sufficient research to draw conclusions allowing the use of cobas in the primary screening of its women while those of us in the United States must wait an additional10 years.
Knowing if the patient had either strain 16 or 18 at the initial time of diagnosis would alert the physician to the fact that this patient will require more close follow-up. With the likelihood that the new guidelines will solidify obtaining a Pap every three years follow-up is already being compromised across the general population. Refusing to appove the use of genotyping until age 30 only further compromises the ability to obtain the earliest diagnosis possible.
Sources:
"Benefits Of Cobas® HPV Test For Primary Screening, England." Medical News Today: Health News. N.p., n.d. Web. 30 Nov. 2011. http://www.medicalnewstoday.com/articles/238255.php
"U.S. Preventive Services Task Force: Draft Recommendation Statement." U.S. Preventive Services Task Force. N.p., n.d. Web. 30 Nov. 2011. http://www.uspreventiveservicestaskforce.org/draftrec4.htm
" HPV Genotyping Clinical Update." ASCCP is the national organization dedicated to the study, prevention, diagnosis, and management of lower genital tract disorders. N.p., n.d. Web. 30 Nov. 2011. http://www.asccp.org/ConsensusGuidelines/HPVGenotypingClinicalUpdate/tabid/5963/Default.aspx
Reviewed November 30, 2011
by Michele Blacksberg RN
Edited by Jody Smith