DNA-based test for HPV has promising results | Agência Brasil

HPV screening in Brazil is set to undergo a major game-changer—the traditional routine cytology test, popularly known as the pap smear, will be gradually replaced by a DNA test.

The incorporation of the technology into Brazil’s public health care network, the SUS, was announced by the Ministry of Health following a study carried out by the State University of Campinas (Unicamp) in the municipality of Indaiatuba, São Paulo. However, it still requires the National Cancer Institute (INCA) to define guidelines and the target population, as well as how the tests will be carried out.

The first five-year round of the study shows promising results from the cervical cancer screening program run in the municipality from October 2017 to September 2022 using the HPV DNA test.

The figures indicate an increase in the detection of precancerous lesions by up to four times, with 83 percent of cancer cases detected at an early stage.

Run by Unicamp’s Center for Comprehensive Women’s Health Care and the Indaiatuba city government, with the support of pharmaceutical company Roche, the survey screened a total of 20,551 women aged 24–65, the target age group.

The HPV DNA test was negative in 87.2 percent of the samples, with 6.2 percent of referrals for colposcopy and 84.8 percent of colposcopies performed. A total of 258 high-grade precursor lesions and 29 cervical cancers (mean age 41.4 years, 83 percent in stage one) were detected.

As a reference, 41,387 cytology or pap smear tests carried out from 2012 to 2016 had detected 36 cervical cancers (average age 52 years), 67 percent of which were in advanced stages.

The results, published in the scientific journal Nature, reveal that the diagnosis of cervical cancer in women screened by HPV DNA in Indaiatuba could be brought forward by ten years compared to cytology tests like the pap smear.

In an interview with Agência Brasil, the director of oncology at Unicamp’s Women’s Hospital and the study’s main researcher, Júlio Cesar Teixeira, said, “After we did the test with high coverage, we detected women who had cancer without symptoms. They were microscopic cancers mostly. We have reversed the scenario [of mostly advanced cancers being detected], saving more women.”

He recalled that the cost-effectiveness analysis for the HPV DNA test showed that DNA testing is more economical.