5th International Conference on Sexually Transmitted Diseases

The next series of the "2nd International Conference on Sexually transmitted Diseases" , "5th International Conference on Sexually Transmitted Diseases" slated on July 17-18, 2019 at London, UK warmly invites you all to present your respective research paper at our conference.

Abstract submission : https://std-hiv-aids.cmesociety.com/abstract-submission
Registration : https://std-hiv-aids.cmesociety.com/registration
Next series blogger info : std2019.blogger.com

Screening HPV infection alone more accurate than Pap test in detection of cervical cancer

Screening for human papillomavirus (HPV) infection alone gives more accurate results than Pap (smear) testing for cervical cancer, say the authors of two papers to published today in the journal Gynecologic Oncology. HPV infection causes almost all cervical cancer, and it is estimated that more than half of sexually active people are infected with HPV at some point in their lives. Now new research has shown that in many cases, an HPV test alone can be used for cervical cancer screening instead of a Pap or cotesting with both an HPV and a Pap test, the researchers say.

In the first paper1, Dr Warner Huh, from the Department of Gynecologic Oncology, University of Alabama, Birmingham, USA, sets out the findings of a panel convened to provide guidance on using HPV as the first-line primary screening test. The panel included representatives from all the major US organizations involved in cervical cancer screening, and addressed questions related to the safety and effectiveness of HPV testing for primary screening and whether it could be considered as an alternative to the screening methods currently in use in the US. The panel was convened because of an application to the Food and Drug Administration (FDA) for an existing HPV test to be used for primary HPV cervical cancer screening. The guidance was based on a literature review and also on review of data from the ATHENA study which was conducted to support the primary screening application to the FDA.

"We found that, in patients aged 25 years and upwards, primary HPV testing performed better than a Pap alone, and we recommend that such tests should be carried out no sooner than every three years. This is an important advance in cervical cancer screening because it offers a better reassurance of low cancer risk compared to Pap screening, which is also carried out at three year intervals," Dr Huh said.

Infection with just two HPV genotypes, 16 and 18, is responsible for about 70% of all invasive cervical cancers worldwide. The panel recommends that patients testing positive for either of these two high risk genotypes should have immediate colposcopy - a procedure using a lighted magnifying device that allows doctors to see abnormal areas in the cervix that would be missed by the naked eye. Women with one of the 12 other HPV genotypes can be followed-up in 12 months with repeat testing with both the HPV test and a Pap.

"We believe that there is still considerable confusion over the three current screening options, and the intervals at which they should be performed. We hope that our deliberations will go some way towards reducing this uncertainty. However, I would still like to see more data from the US, and evidence from other countries using primary HPV screening such as Australia and The Netherlands. But in the absence of data to the contrary, we believe that primary HPV testing has potential to further reduce cervical cancer in the US," Dr Huh said.

The second paper2 reveals end-of-study results of the ATHENA trial which evaluated safety and effectiveness of HPV primary screening as an alternative to Pap in women of 25 years and older. 42,209 women in this age group were enrolled into the trial and had both Pap and HPV testing. Those with abnormal Pap test results and those who were HPV positive were referred for colposcopy.

"We found that HPV primary screening was as effective in women aged 25 years and over when compared to Pap alone for women 25 and 29 and cotesting for those aged 30 and over. However, HPV screening alone requires only one test, and this is important for many women who may not be able to afford the cost of two tests," said Dr Thomas Wright, a Professor Emeritus of Pathology and Cell Biology at Columbia University, New York, USA.

To determine the impact of starting HPV screening at different ages, the researchers compared the prevalence of HPV positivity and Pap abnormalities as well as the three year detection rate of high-grade cervical disease by age group. They found that although HPV positivity was almost twice as high in women aged 25-29 as it was in women aged 30-39, HPV testing identified about twice as many high-grade cervical disease cases in women aged 25-29 than did the Pap.

"When Pap screening is used in this age group, the women with missed high-grade cervical disease are told to return in three years for repeat screening and some are likely to develop invasive cervical cancer", said Dr Wright.

"Our results, from the first prospective US study to evaluate the performance of HPV primary screening, have shown clearly that this new screening approach should be considered as an option for women 25 years and older", Dr Wright said. However, he added that the recent FDA approval for HPV primary screening is limited to a single commercially available HPV test and to only one of the two widely utilised liquid-based Pap tests. "In order to facilitate the widespread adoption of this safe and effective method of screening, it would be advantageous to have additional HPV tests and the other liquid-based Pap tests approved. We hope that our research will help reduce morbidity and mortality from cervical cancer worldwide," he said.

Source: https://medicalxpress.com/news/2015-01-screening-hpv-infection-accurate-pap.html

HPV Vaccination in Prevention of Cervical Cancer: Review

The human papillomavirus or HPV spreads through intimate contact during sex with someone who is infected. In some women, an HPV infection will persist and lead to cervical cancer. HPV vaccines protect against cervical cancer in young women, especially when the women are vaccinated between the ages of 15 and 26, a new Cochrane Report finds.

The report's authors, who examined evidence from 26 previously published studies of more than 70,000 women, also found no serious side effect risks associated with the vaccines.

Most people who have sexual contact will be exposed to HPV at some time. Even if exposed, most women will clear the viral infection naturally. However, a persistent infection could lead to abnormal cervical cells, called cervical "pre-cancer" since these cells can slowly progress to cancer if not treated.

"Cervical cancer is the fourth most frequent cancer in women in the world," said lead author Dr. Marc Arbyn of the Unit of Cancer Epidemiology at the Belgian Cancer Centre in Brussels. More than half a million cases are diagnosed each year, and about half of these women will die of the disease, he said.

Though there are many types of HPV, only some strains raise a woman's risk for developing cervical cancer; HPV16 and HPV18 account for about 70% of all cases of cervical cancer worldwide.

For the new review, Arbyn and a team of researchers evaluated study evidence for two commercially available HPV vaccines: Cervarix, which targets HPV16 and HPV18 only, and Gardasil, which takes aim against those strains plus two HPV types that cause genital warts.

The World Health Organization recommends HPV vaccination for both girls and boys between the ages of 9 and 14. The United States, the UK, Australia and nations in the European Union all have similar if slightly different guidelines, though only some include boys. Since not all the studies in the review included boys, the researchers did not examine evidence of HPV vaccine effectiveness pertaining to men.

In women between the ages of 15 and 25 who tested negative for HPV before receiving the vaccine, the risk of precancer associated with HPV16 or HPV 18 was 164 for every 10,000 unvaccinated women, compared with just two per 10,000 vaccinated women. The vaccines also reduced the risk of any cervical precancer (whether caused by the two HPV types or not) from 287 to 106 for every 10,000 women.

In older women -- those vaccinated between the ages 25 and 45 -- the effects of HPV vaccine were smaller, the authors estimate. Unvaccinated versus vaccinated, the risk of precancer associated with HPV16 and HPV18 dwindled from 145 to 107 for every 10,000 women. This is probably due to the women having been previously exposed to HPV, the authors said, adding that the vaccine did not provide protection against any cervical precancer.

Despite claims and reports that the vaccine causes neurological issues -- including seizures -- Arbyn and his colleagues found local reactions, such as a swollen arm, when receiving either of these two vaccines but "no increased incidence of serious adverse effects." However, the reviewers added that "evidence on rare potential harms ... are difficult to capture" in the types of studies reviewed.

Dr. Jo Morrison, a consultant in gynaecological oncology at Musgrove Park Hospital in Somerset in the UK, said the claims that the vaccine damages young girls "are not substantiated by the evidence." Morrison, who was not involved in the study, added, "going down this road risks causing harm by reducing vaccination rates."

Overall, Morrison believes "the review reassures people that HPV vaccination is effective. They should be encouraged to vaccinate their daughters, as per the government recommendation."

Helen Bedford, a professor at University College London's Institute of Child Health, noted that "HPV vaccine was introduced 10 years ago for 13- to 14-year-old girls to prevent infection with HPV, which can lead to cancer of the cervix."

"This, together with early evidence of reduction in cervical cancer in Finland, confirms the ground breaking value of this cancer-preventing vaccine," said Bedford, who was not involved in the study. "It also provides reassuring evidence of the safety of HPV vaccines."

To know more about the session Vaccines Development in the conference STD 2018, visit: http://bit.ly/stdcoavd2018

Source: https://edition.cnn.com/2018/05/08/health/hpv-vaccines-cervical-cancer-review/index.html