A new study by Cancer Council NSW and the Victorian Cytology Service (VCS Ltd.) has presented results from the first phase of Australia’s biggest clinical trial. The Compass trial looks at how effectively HPV screening detects high-grade cervical abnormalities in comparison to cytology (i.e. the Pap test). For the first time ever, the trial compares HPV screening with Pap tests in a population with substantial uptake of the HPV vaccine.
“We found that the HPV test was substantially more effective at picking up high-grade abnormalities compared to the Pap test.” Professor Karen Canfell
The findings come as Australia prepares to transition to a renewed National Cervical Screening Program, which, among other changes, will introduce primary HPV screening. The new system will come into place in December this year, so the study is a timely confirmation of just how effective the new program is expected to be – not just in unvaccinated women, but also in those who were offered the HPV vaccine.
“Our study of about 5,000 participants found that compared to Pap tests, HPV screening provides significantly increased detection of high-grade cervical abnormalities,” Professor Karen Canfell, Director of Research at Cancer Council NSW, said.
“We found that the HPV test was substantially more effective at picking up high-grade abnormalities compared to the Pap test.”
The increased detection of high-grade abnormalities of precancerous lesions (CIN2 or higher), and earlier treatment leads to longer term protection against the development of CIN3 and invasive cancer.
“This adds to existing evidence about how much more accurate and effective HPV screening is. We now have a superior method for detecting not just the virus that causes cervical cancer, but also high-grade abnormalities,” Prof Canfell said.
The new screening program has previously been estimated to lower cervical cancer incidence and mortality by at least 20 per cent – thanks to the more accurate, effective and safe test.
In its first phase (the results of which are presented in this study), the Compass trial recruited women aged 25-64 who attended a routine screening at 47 participating practices in Victoria, Australia. The women provided a cervical sample, and were then sent on the management pathway that will be put into place in Australia as part of the renewed National Cervical Screening Program this December.
The second phase of the Compass trial is currently recruiting. Its target is 121,000 participating women presenting for either routine screening or follow-up management, making it the largest clinical trial ever undertaken in Australia. The investigators have recently been able to open up recruitment to South Australian women while continuing recruitment in Victoria.
“Women residing in Victoria and South Australia aged 25 to 38 years are likely to be eligible to participate and can get more information on the trial’s website – compasstrial.org.au,” A/Prof Saville concluded.
Source: Cancer Council NSW