HPV screening seminar a success
With over 210 attendees,
the September CAP Strategic Science seminar “HPV screening:
Are you ready for a new era in cervical cancer screening?” was
filled to capacity. The conference organizers were gratified by the
interest and regretted that not everyone could be accommodated. To
purchase conference notebooks containing abstracts and Powerpoint
handouts ($75 for members, $100 for nonmembers), call the CAP education
department at 800-323-4040 ext. 7525.
Diane D. Davey, MD
Proceedings of the seminar will appear in Archives of Pathology &
Laboratory Medicine, and a half-day seminar summarizing the conference
will take place during the fall 2003 CAP meeting in San Diego.
The era of human papillomavirus testing represents a paradigm shift
in cervical cancer screening and followup studies. HPV is a necessary
but not sufficient agent for the development of cervical cancer. Many
women become infected with HPV, but only a few develop high-grade
squamous intraepithelial lesions or cancer. Persistent infection (lasting
at least 11/2 years) with an oncogenic HPV means a woman has a good
chance of developing a high-grade lesion or cancer.
Speakers at the conference discussed appropriate uses for HPV testing,
including the recently published clinical management guidelines developed
under the leadership of the American Society for Colposcopy and Cervical
Pathology. In patients with atypical squamous cells of undetermined
significance, HPV testing is at least as sensitive as immediate colposcopy
in detecting biopsy-proven high-grade lesions. HPV testing is more
sensitive than cervical cytology as a primary screening tool, although
the FDA has not yet approved it for this use. Combined cytology and
HPV testing offers nearly 100 percent negative predictive value in
excluding high-grade lesions. Patient advocate Nancy Roach discussed
patient and public health educational issues. Many women know little
about the role of HPV in cervical carcinogenesis.
Strategic Science, a multimodal continuing education series, integrates
science with laboratory management and includes an online pre-conference.
September Strategic Science speakers addressed HPV testing methods,
new technology assessment, quality assurance, regulatory compliance,
risk management and safety, billing and coding, cost analysis, information
management, and results reporting. As speakers stressed, there is
no universal answer to the question: Should HPV tests be performed
in-house or sent out? Laboratories must consider volumes, local clinical
practices and expectations, and payer mix, among other issues.
Dr. Davey is past chair of, and former advisor to, the CAP Cytopathology
Committee and professor of pathology and laboratory medicine and
laboratory director of the cytopathology and bone marrow laboratories
at the University of Kentucky Chandler Medical Center, Lexington.