What next for the development of HPV tests?
Kate Cushieri, Director HPV Reference Laboratory, Edinburgh
Which test is used is a crucial; component of effective cervical screening programmes and increasingly HPV testing is used. In this presentation Kate provides an overview of that is new and evolving in the sphere of HPV testing in Cervical Screening.
264 distinct different HPV tests available but not all evaluated comprehensively as suitable for Cervical screening programmes. Validation ongoing - update really needed - Longitudinal performance , target lesion, Duration of follow up, Storage, Sample adequacy, viral load, reproducibility
Impact of HPV vaccination - what does this mean for HPV testing? Viral unmasking could reduce the specificity and impact on PPV. Clinical unmasking? Impact on natural history? (Difficult to be sure here). Sensitivity should not change and that’s important when screening programmes involved
Future Reduction in screening interval for vaccinated women - ongoing evaluation
Genotyping? Focus on HPV 16/18 ? Remove HPV other? Risk stratification could be based on this.
but it is not currently part of the management algorithms.
Useful resource: Iarc handbook on HPV prevention
Testing in LMIC - two tests in a lifetime 90% 1.4-1.5 billion tests , Cheap robust and reliable point of care type tests
New technology for follow up? Liquid biopsies - HPV testing which can be detected in blood - follow up after cancer