Enhancing cervical cancer management with dual stain


Carolyn Kay, MD, discusses the latest ASCCP guidelines and the introduction of dual stain cytology for improved HPV detection and patient management, aiming to alleviate anxiety and enhance efficacy in cervical cancer prevention.

In a recent interview, Carolyn Kay, MD, medical affairs lead at Roche Diagnostics, discussed new ASCCP guidelines about cervical cancer management.

Patients will often feel anxiety when HPV is detected in their system. This anxiety often relates to having to wait a year before coming back and getting retested. Kay expressed feeling a similar anxiety at times because of not always knowing if the patient would come back for additional testing.

Often, Kay would have patients who did not have precancerous lesions needing intervention for multiple years in a row. She noticed the repeated testing led to anxiety and frustration in some patients.

With the new tool, clinicians will be able to determine if an HPV infection is leading to precancerous changes on a molecular level. This will also lead to greater efficacy for identifying patients who should be recommended to receive a coloscopy. Guidance from the ASCCP will help clinicians manage cases where HPV is detected.

The new method for managing patients with HPV is referred to as dual stain cytology. It detects the P-16 and KI-67 biomarkers that indicate cell cycle rest and cell cycle progression, respectively. When both markers are detected in the same cell, this indicates cell cycle dysregulation and is associated with precancerous changes on the cervix.

Since the 1970’s, cervical cancer incidence has decreased by over half in the United States. This decrease is because of guidelines for managing precancerous conditions, but more work is necessary to reduce disparities in the health care system, according to Kay.

Kay believes the dual stain will simplify decision making, with increased accuracy compared to the current standard of care. It requires fewer coloscopies and detects cervical intraepithelial neoplasia stage 3 earlier compared to the current standard of care.

While progress has been made, cervical cancer is not decreasing equally across US populations, with patients still dying from this preventable disease. Kay concluded by stating providers should consider how different communities are impacted by these new technologies.

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