Co-testing May Detect Invasive Cervical Cancer Better Than HPV-only Screening
Not only may co-testing help detect more cases of invasive cervical cancer, but it also may lower overall health care costs.
Not only may co-testing help prevent more cases of invasive cervical cancer compared with screening for only human papillomavirus (HPV), but it also may lower overall health care costs.1
The clinical-economic modeling analysis was presented in poster form at the International Society for Pharmacoeconomics and Outcomes Research 18th Annual European Congress in Milan.
Co-testing, which uses both an mRNA-based HPV and a liquid-based Papanicolaou test in combination, provides “the benefit of better detection, more saved lives, and not only is it not cost adverse, but it's actually cost beneficial,” the study's lead author, Juan Felix, MD, told Cancer Therapy Advisor.
Dr Felix, chief of cytopathology for the Los Angeles County + University of Southern California Medical Center in Los Angeles, CA, said the study used a Markov model to simulate the lifetime effects of screening 100 million women every 3 years between the ages of 30 and 70 years. The analysis predicted that co-testing would prevent nearly 150 000 cases of invasive cervical cancer and save approximately $4 billion.
“Every cancer case you prevent represents a woman not having a radical hysterectomy, radiation therapy, or chemotherapy,” Dr Felix said. “So every cancer prevention represents a couple of hundred thousand dollars saved.”
Additional savings, he said, would come from the increased sensitivity of co-testing in detecting cervical cancer.
“The factors that go into the costs are not only the cost of the test itself but, of course, the consequences of the test,” Dr Felix said, “meaning if one test has less specificity, there will be more false positives. More false positives would result in additional colposcopies, biopsies, and therapies.”
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The study comes as a direct response to a 2015 Interim Guidance Report from the Society of Gynecologic Oncology (SGO) and the American Society for Colposcopy and Cervical Pathology (ASCCP) that said HPV testing alone was an effective alternative to co-testing or a Papanicolaou test alone.2
The guidance report was published after the U.S. Food and Drug Administration approved the cobas HPV Test as a “primary” screening test. The test detects DNA from 14 high-risk HPV types, including types 16 and 18, which are responsible for 70% of cervical cancers.