Molecular triaging options for women testing HPV positive with self-collected samples

Area of Science:

• Gynecology
• Oncology
• Molecular Diagnostics

Background:

• Cervical cancer elimination strategies rely on sensitive screening methods like high-risk human papillomavirus (hrHPV) testing.
• Current hrHPV screening alone may lead to overtreatment in women of reproductive age.
• Self-collection of samples increases screening coverage, creating opportunities for optimized triage.

Purpose of the Study:

• To review advancements in molecular triaging for hrHPV-positive women using self-collected samples.
• To assess the potential of molecular biomarkers to improve the accuracy and efficiency of cervical cancer screening.
• To explore strategies for minimizing overtreatment in women undergoing cervical cancer screening.

Main Methods:

• Review of current literature on molecular triaging techniques for hrHPV-positive samples.
• Analysis of methods including partial/extended genotyping, methylation tests, E6/E7 protein detection, and hrHPV viral load.
• Comparison of molecular triage with conventional methods like cytology and visual inspection with acetic acid (VIA).

Main Results:

• Molecular triaging offers enhanced prediction of cervical intraepithelial neoplasia grade 2 or worse (CIN2+) and invasive cancer.
• Molecular methods can be applied to self-collected samples, aligning with hrHPV screening.
• Conventional triage methods are not suitable for self-collected samples and require additional clinic visits.

Conclusions:

• Molecular triaging holds promise for more precise, efficient, and cost-effective cervical cancer screening.
• Further research is needed to validate cost-effectiveness and efficacy in diverse populations.
• Implementing molecular triaging can improve screening accuracy and reduce healthcare burdens, aiding cervical cancer elimination efforts.