A new study by Cancer Council NSW has found that HPV-based cervical screening in Australia is predicted to decrease a woman’s lifetime risk of cervical surgery, compared to the current Pap test program. As a consequence, the research also predicts a decrease in the number of pregnancy complications that can potentially arise from such surgery.
HPV screening – the system that Australia is transitioning to this December – enables earlier diagnosis of cervical lesions. It is expected to decrease cervical cancer rates and mortality by at least 20 per cent, and its impact on screening benefits has been widely demonstrated. However, its effect on the risk of cervical treatment hasn’t been looked at in detail so far.
Surgical treatment of high-grade abnormalities is one of the potential outcomes of screening – treating precancerous lesions avoids cancer developing down the track. In the large majority of women, treatment is necessary and there are no adverse effects. However, treatment can be unnecessary – in women under 25, it is estimated that up to 70 per cent of high-grade abnormalities (CIN 2/3) would regress on their own, without intervention. This is one of the reasons that the new cervical screening program involves starting screening women from their 25th birthday.
Previous research also showed that treatment of abnormalities detected during cervical screening might increase the risk of pregnancy complications later in life.
“The good news is that we have found that when the new cervical screening program comes into place, vaccinated women will be at a 13 per cent lower risk of cervical surgery over their lifetime compared to if Pap smear screening was maintained, and therefore they will also be less likely to have adverse pregnancy outcomes,” said Professor Karen Canfell, Director of Research at Cancer Council NSW.
“Specifically, we estimate that HPV screening will lead to up to 4-41 fewer preterm deliveries in 100,000 women, and up to 52 fewer low birthweight events per 100,000 women, compared to the existing Pap smear-based cervical screening program.”
“With the combined impact of HPV vaccination and the new cervical screening program, the rates of detected abnormalities, treatments, and the potential for associated pregnancy complications after cervical screening are expected to be much lower than before.
“This is another reassuring piece of research in the lead-up to the implementation of the renewed screening program – it gives us a glimpse into how well the integration of HPV vaccination and HPV screening is set to work here in Australia,” Prof Canfell concluded.
Source: Cancer Council NSW