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HPV testing

  1. How is HPV testing being used within CervicalCheck?
  2. Why is HPV testing being done following colposcopy treatment?
  3. Can a HPV test be ordered in primary care through CervicalCheck?
  4. Where can I learn about HPV and HPV testing?

How is HPV testing being used within CervicalCheck?

HPV triage - reflex HPV testing

Women who attend for cervical screening will have their samples also tested for HPV if cytology detects low grade abnormalities (ASCUS or LSIL). The HPV test helps to determine the recommen dation to be assigned with the result by the laboratory. This recommendation will be for routine screening if HPV is not detected, and will be refer to colposcopy if HPV is detected. 

Women who are referred to colposcopy with low grade cytology and HPV deteced will have a colposcopy and/or a biopsy. If there is no CIN present, these women will be discharged for a smear test in 3 years (regardless of age). If there is CIN present, these women will be managed in colposcopy until they can be discharged.

Further information:

 

HPV testing within colposcopy services

Women are offered combined smear and HPV tests in programme colposcopy clinics. The combined smear and HPV tests are used for women post treatment, and for women with persistent low grade cytological abnormalities but who do not require treatment.

For women who are post treatment, HPV testing is designed to improve the early detection of women who may require repeat treatment. In addition, HPV testing informs the risk assessment of women prior to discharge, and can lead to discharge recommendations of routine screening (rather than annual surveillance screening) for increased numbers of women.

Further information:

 

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Why is HPV testing being done following colposcopy treatment?

HPV testing is designed to improve the early detection of women who may require repeat treatment and to avoid increased testing for women at low risk of recurrence. The traditional follow up of treated women involved annual cytology screening for 10 years before they return to routine screening. The introduction of HPV testing will allow many women to avoid annual smear tests.

Further information:

 

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Can a HPV test be ordered in primary care through CervicalCheck?

No, it is not possible to order a HPV test in primary care through CervicalCheck at this time. HPV testing is only being provided as a reflex test when low grade cytological abnormalities are found in a screening smear test sample. Separately, HPV testing is usedin CervicalCheck colposcopy settings.

 

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Where can I learn about HPV and HPV testing?

The Guide for Smeartakers provides an overview of HPV in relation to cervical cancer.

Further information:

 

Evidence based papers and further reading:

Castellsagué X. (2008) Natural history and epidemiology of HPV infection and cervical cancer. Gynecol Oncol. 2008 Sep;110(3 Suppl 2): Unit of Infections and Cancer, Institut Català d'Oncologia, IDIBELL, CIBER-ESP. S4-7xcastellsague@iconcologia.net

Cuschieri KS, Cubie HA. (2005) The role of human papillomavirus testing in cervical screening. J Clin Virol. 2005 Mar;32 Suppl 1:S34-42.

Jones J, Saleem A, Rai N, Shylasree TS, Ashman S, Gregory K, Powell N, Tristram A, Fiander A, Hibbitts S. (2011) Human Papillomavirus genotype testing combined with cytology as a 'test of cure' post treatment: the importance of a persistent viral infection. J Clin Virol. 2011 Oct;52(2):88-92. Epub 2011 Aug 9.

Matsumoto K, Oki A, Furuta R, Maeda H, Yasugi T, Takatsuka N, Hirai Y, Mitsuhashi A, Fujii T, Iwasaka T,et al. (2010) Tobacco smoking and regression of low-grade cervical abnormalities. Cancer Sci 2010;101:2065–2073.

MCCaffrey K, Waller J, Nazroo J, Wardle J, (2006). Social and Psychological impact of HPV testing in Cervical Screening: A qualitative study. Sex transm infect 2006; 82(2): 169-74.

McIntyre-Seltman, K., Castle, P., Guido, R., Schiffman, M., Wheeler, C. (2005): Smoking is a Risk Factor for Cervical Intraepithelial Neoplasia Grade 3 among Oncogenic Human Papillomavirus DNA–Positive Women with Equivocal or Mildly Abnormal Cytology. Cancer Epidemiology Biomarkers & Prevention Vol. 14, 1165-1170.

Mesher D, Szarewski A, Cadman L, Cubie H, Kitchener H, Luesley D, Menon U, Hulman G, Desai M, Ho L, Terry G, Williams A, Sasieni P, Cuzick J. (2010): Long-term follow-up of cervical disease in women screened by cytology and HPV testing: results from the HART study. Br J Cancer. 2010 Apr 27;102(9):1405-10. Epub 2010 Mar 30.

 

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Is cuid den tSeirbhís Náisiúnta Scagthástála é CervicalCheck
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CervicalCheck is part of the National Cancer Screening Service
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Is cuid den Rannóg Sláinte agus Folláine i bhFeidhmeannacht na Seirbhíse Sláinte í an tSeirbhís Náisiúnta Scagthástála. Cuimsíonn sí BreastCheck – An Clár Náisiúnta Scagthástála Cíoch, CervicalCheck – An Clár Náisiúnta Scagthástála Ceirbheacs, BowelScreen – An Clár Náisiúnta Scagthástála Putóige agus Diabetic RetinaScreen – An Clár Náisiúnta Scagthástála Reitiní do Dhiaibéitigh.

The National Screening Service is part of the Health and Wellbeing Division of the Health Service Executive. It encompasses BreastCheck – The National Breast Screening Programme, CervicalCheck – The National Cervical Screening Programme, BowelScreen – The National Bowel Screening Programme and Diabetic RetinaScreen – The National Diabetic Retinal Screening Programme.