Looking any information whether there is rapid point of care molecular methods to screen/diagnose cervical cancer associated with HPV infection.
Dear Awoke Derbie
Pls. find the attached files and the references, good luck
Hoping this will be helpful to your project
Regards
Prof. Houda Kawas
https://academic.oup.com/jnci/article-abstract/87/11/796/1141620
http://www.zervita.de/gfx_content/Dokumente/HPVgenotypeAttributionInvasive%20CervicalCancerRetospective%20study.pdf
http://www.medscape.com/viewarticle/842373_5
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4951329/
https://www.mlo-online.com/point-of-care-testing-and-its-implications-for-stis
http://www.sciencedirect.com/science/article/pii/S2405852115300112
...
https://www.mdtmag.com/article/2016/05/point-care-highly-accurate-cervical-cancer-screening
http://ir.cepheid.com/releasedetail.cfm?releaseid=837096
https://www.cancer.gov/about-cancer/causes-prevention/risk/infectious-agents/hpv-fact-sheet
https://my.clevelandclinic.org/health/articles/understanding-hpv
...
http://www.hu.ufsc.br/projeto_hpv/Molecular%20diagnosis%20of%20human%20papillomavirus%20(HPV)%20infections.pdf
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822006000500002
https://virologyj.biomedcentral.com/articles/10.1186/1743-422X-9-262
https://molecular.roche.com/news/roche-submits-filing-to-fda-for-cervical-cancer-primary-screening-indication-for-cobas-hpv-test/
...
https://www.intechopen.com/books/human-papillomavirus-and-related-diseases-from-bench-to-bedside-a-diagnostic-and-preventive-perspective/molecular-diagnosis-of-human-papillomavirus-infections
https://molecular.roche.com/news/roche-submits-filing-to-fda-for-cervical-cancer-primary-screening-indication-for-cobas-hpv-test/
https://academic.oup.com/labmed/article-lookup/doi/10.1309/LM75WGJSVMI7VVEF
Good luck
http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0036-36342009000900014
https://www.labce.com/hpv_cervical_cancer.aspx
https://www.ncbi.nlm.nih.gov/pubmed/20464222
http://www.nejm.org/doi/full/10.1056/NEJMoa021641
HPV Diagnosis in the Developing World
In contrast to the acute illnesses caused by febrile viruses, the requirements for chronic diseases may be somewhat different. For febrile illnesses, the goal is to provide immediate treatment to the patient and minimize the spread of infection. For viruses such as HPV, no acute symptoms are present, and the clinical challenge is to monitor infections with the potential to lead to serious outcomes later in life.
HPV infection is the known causative agent for cervical cancer, with a >99% correlation.[81,82] Worldwide, cervical cancer stemming from HPV infection causes more than 500,000 cases and 275,000 deaths annually.[83] Over 87% of the deaths occur in developing nations.[84,85] Within developed nations, due to the negative predictive value of an HPV test, the standard of care is fast becoming HPV screening, with positive HPV detection being accompanied by more frequent Papanicolaou (Pap) tests.[86] This clinical paradigm is highly efficient in high-infrastructure regions that support broad community screening programs and in which women have readily available access to healthcare infrastructure that allows them to be screened at relatively frequent intervals. Pap tests can be interpreted by trained cytologists, and patients can be further evaluated by colposcopy or cervical biopsy as needed.
In developing nations, cervical cancer is the second leading cause of cancer incidence and third leading cause of cancer mortality.[87] The high incidence and associated mortality have led to efforts to adapt HPV viral diagnostics for the POC in the developing world. For example, thecareHPV™ (QIAGEN N.V., Venlo, The Netherlands) test for low-resource settings is highly complementary with QIAGEN's digene Hybrid Capture 2 (HC2) HPV test, currently recognized as the gold standard for HPV screening in developed countries. The careHPV test takes 2.5 h to perform, requires a trained technician due to only partial automation, and is designed to run only in batch mode.[88–90] In comparison, Cepheid's GeneXpert® HPV assay can be performed in 1 h, in a nonbatch mode, with clinical sensitivity and specificity performance comparable to the HC2.[91] The cost of the cartridge and instruments remains a major limitation to its widespread adoption. Although other groups continue to work on extending HPV testing into the developing world,[92,93] the tests in general remain too expensive and technically challenging to be used in settings with minimal healthcare infrastructure.[85]
The clinical success of HPV testing will depend critically on the attention given to every step of the translation process. This is particularly true because the viral diagnostic is of limited utility in directly determining a treatment direction. Even for high risk, oncogenic HPV types such as HPV-16 and -18 over 80% of women will spontaneously clear the infection with no adverse consequence.[94] Thus, the critical first question in the design of an HPV viral diagnostic is how will the test result be used to make therapy decisions? In industrialized nations, the answer to this question is straightforward due to the availability of multiple reflex tests and high rates of patient follow-up. In low-infrastructure settings such as are found in the developing world, women are more likely to be tested once or twice in their lifetime with high rates of loss to follow-up. Furthermore, reflex testing options may be minimal. In some portions of the world, women at risk for cervical cancer are immediately reflexed to radical hysterectomy.[95] While this remains an extreme example, in many developing nations a positive HPV test is directly followed with procedures such as cryotherapy, surgical ablation and loop electrosurgical excision procedure.[87,96] Given that up to 80% of those treated are not at risk, the result is a large overuse of medical intervention, with associated cost and infrastructure burden, and potential morbidity, particularly for women in their child-bearing years. Thus, developers of an HPV viral diagnostic may well ask themselves if diagnosis of the virus in isolation brings maximal clinical utility.
One recent approach has been to combine viral diagnosis with other markers of disease progression. In the case of HPV, detection of the virus in conjunction with host protein biomarkers has been shown to provide increased specificity for the population of interest: namely, those women likely to progress to cervical cancer.[97,98] Numerous biomarkers have been evaluated for their ability to detect high-grade cellular dysplasia, including cell proliferation biomarkers such as Ki-67,[99–102] MCM2,[103,104] MCM6[105] and TOP2A,[103,106,107] as well as other markers capable of detecting high-grade dysplasia including MMP7,[108,109]CD63[108] and CCNE1.[110,111] Although no single biomarker has been shown to detect dysplasia with high clinical sensitivity and specificity, combinations of biomarkers offer the potential for accurately predicting HPV infections likely to progress to dysplasia.[85,99,112] Recently two and three biomarker combinations such as p16INK4A/Ki-67[99,113] and p16INK4A/ProExTM C (Becton, Dickinson and Company, NJ, USA; MCM2 and TOP2A)[114] have distinguished immature metaplasia from high-grade lesions. Technical approaches that combine direct virus detection with markers of cervical cellular dysplasia may thus result in broader clinical utility at the POC, reducing unnecessary medical interventions and allowing limited resources to be focused on those women most likely to advance to cervical cancer.
While the success of such approaches has yet to be determined in clinical studies, they provide important examples of how a successful viral diagnostic may detect more than the virus itself. Combinations of genomic and protein markers or of viral and host biomarkers may ultimately provide the greatest clinical utility.
Hi Awoke
Some useful references on attachment 1
https://www.cancer.gov/types/cervical/pap-hpv-testing-fact-sheet
2
https://www.nccc-online.org/hpvcervical-cancer/cervical-cancer-screening/
5
https://www.who.int/cancer/prevention/diagnosis-screening/cervical-cancer/en/
6
https://www.cancerscreening.gov.au/internet/screening/publishing.nsf/content/cv-hpv
7
https://www.cancerscreening.gov.au/internet/screening/publishing.nsf/content/cv-hpv
10
https://www.cancer.org/cancer/cervical-cancer/prevention-and-early-detection/hpv-test.html
11
https://www.cancer.org/cancer/cervical-cancer/detection-diagnosis-staging/how-diagnosed.html
14
https://www.nhs.uk/news/cancer/hpv-urine-test-could-screen-for-cervical-cancer/
17
https://www.cancer.ca/en/cancer-information/cancer-type/cervical/screening/?region=on
18
http://pinkribbonredribbon.org/wp-content/uploads/2017/02/Investing-in-Cervical-Cancer-Screening-1.pdf
19
https://www.healthline.com/health/sexually-transmitted-diseases/hpv-in-men
20
https://www.uspreventiveservicestaskforce.org/Page/Document/risk-factors-and-other-epidemiologic-considerations-for-cervical-cancer-screening-a-narrative-review-for-the-us-preventive-services-task-force/cervical-cancer-screening
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