New cervical cancer test may predict risk

A new tool for assessing cervical cancer risk may offer clinicians a simpler method for making treatment decisions than commonly used management algorithms, according to an article published online Sept. 20 in The Lancet Oncology.

Hormuzd A. Katki, M.D., of the National Cancer Institute in Bethesda, MD, and colleagues are developing a tool that uses cervical precancer, best defined as a histological cervical intraepithelial neoplasia (CIN) grade 3 or higher (and less precisely defined as a grade 2 or higher), as a common treatment threshold.

The authors write that the new tool-a preliminary version of which is expected to be available in 2010-will allow clinicians to use their personal digital assistants or computers to calculate a woman's current, 1-year, 3-year, and 5-year risk of developing cervical precancer based on the patient's age, current test results, and available past test results. For example, it might show that a 33-year-old woman with persistent human papillomavirus-16, high-grade cytology, and high-grade colposcopic impression has a 5-year risk exceeding 80%, suggesting that surgery to remove lesions might be necessary even in the absence of biopsy confirmation.

Katki HA, Wacholder S, Solomon D, et al.. Risk estimation for the next generation of prevention programmes for cervical cancer. The Lancet Oncology, Early Online Publication, 20 September 2009. doi:10.1016/S1470-2045(09)70253-0