BD blog: The future of cervical cancer screening: More genotypes means more precise care
Jan 18, 2022
The future of cervical cancer screening: More genotypes means more precise care
By Molly Broache, Associate Director, Medical Affairs for US IDS
I was talking with a friend recently about the work our BD Women’s Health team is doing around HPV 31 and not only did she ask what HPV is (human papillomavirus) but also she wondered why HPV 31 was so important.1-6 When I explained that HPV is tied to cervical cancer, she went on to tell me—with some embarrassment—that she didn’t actually know what type of cervical cancer screening she was receiving, nor where to go to learn more. No one should be embarrassed to ask these questions, and healthcare practitioners have the opportunity to do more to proactively educate women about this absolutely critical information.
So, let’s talk candidly and simply about HPV—what it is, why it’s so important for people with cervixes to be tested using an HPV test with extended genotyping, and how to make sure your (or your daughter’s, partner’s, sister’s or mother’s) OB/GYN is offering you the most thorough test available.
According to the CDC, HPV is the most common sexually transmitted infection and there are many different kinds of HPV7-8. While the majority of HPV types lead to unpleasant things like genital warts, 14 HPV types, called high-risk genotypes (types), can become cervical cancer9 if they are not identified early enough to take action. For quite some time, the main high-risk types that the medical industry paid attention to were HPV 16 and HPV 18. These have always been considered the “scariest” to test positive for, and if you test positive for one of these, you are usually sent directly to a colposcopy, which is a diagnostic procedure with the goal of closer visualization of the cervix, and a biopsy if deemed necessary.
The first-generation HPV vaccine was FDA-approved in 2006. It targeted four types of HPV (which is why it’s often called the quadrivalent vaccine), including types 16 and 18. Fast forward to today when the girls who received the quadrivalent vaccine are now young women and eligible for routine cervical cancer screening. As these women continue to enter our screening population, we are finding that HPV 16 and 18 are decreasing in prevalence, making it crucial to identify the other high-risk HPV genotypes.10-11 One of these other high-risk genotypes, HPV 31, has a similar risk profile to HPV 18, which means it has a high likelihood of progressing to pre-cancer. Based on the ASCCP’s (American Society for Colposcopy and Cervical Pathology) risk-based management consensus guidelines, women who test positive for HPV 31 should also be sent for a colposcopy to determine the need for treatment.2,4,12-16
But here’s the catch: Only one HPV test is FDA approved to identify HPV 31 individually. All other tests offer what is called partial genotyping, where they individually identify HPV 16 and 18, or 16 and 18/45, but report the other high-risk HPV types in a single, pooled result.4,12 This pooled result may mask a woman’s true risk of cervical pre-cancer or cancer due to HPV 31, and, in women with normal cytology results, will likely lead to a one-year follow-up recommendation instead of an immediate colposcopy referral.1,4,15
If you knew you had tested positive for a more aggressive, high-risk HPV type, would you want to “wait and see,” potentially letting it progress to pre-cancer by the time you retest? Me neither.
The one test that individually identifies HPV 31 is readily available to your OB/GYN and to you: The BD Onclarity™ HPV Assay with extended genotyping.
So how do you talk to your doctor about it to make sure you’re getting the most accurate cervical cancer screening possible?
Before your next visit, you can start by asking what HPV test the doctor is using now. Ask what HPV types they see in the results from the lab. Are they seeing types 16 and 18? What about 31?
- Then tell them you wanted to be tested for HPV with the BD Onclarity™ HPV Assay. It tests for HPV 31, which carries a similar risk as HPV 18.16
- Tell your doctor to ask their lab to carry the BD Onclarity™ HPV Assay and to visit our new women’s health website, womens-health-solutions.bd.com, to see the research behind HPV 31 and to learn more about it.
Please—don’t let embarrassment or shyness stop you from demanding the best. Women deserve to know what’s going on in their own bodies. Women deserve the most precise care that comes from having the right diagnosis in the first place.
Learn more about HPV 31 on the BD Women’s Health Solutions website.
1. Bonde JH et al. J Low Genit Tract Dis. 2020;24(1):1-13.
2. Perkins RB et al. J Low Genit Tract Dis. 2020;24:102-131.
3. Demarco M et al. EClinicalMedicine. 2020;22:100293.
4. Stoler MH et al. Gynecol Oncol. 2019;153(1):26-33.
5. Bonde J et al. Int J Cancer. 2019;145:1033-1041.
6. Elfgren K et al. AM J Obstet Gynecol. 2017;216(3):264e1-264.e
7. STD Facts - Human papillomavirus (HPV) (cdc.gov)
8. Basic Information about HPV and Cancer | CDC. Cdc.gov. https://www.cdc.gov/cancer/hpv/basic_info/index.htm. Published 2018. Accessed August 25, 2020.
9. World Health Organization. Human papillomavirus (HPV) and cervical cancer. Available at: https://www.who.int/news-room/fact-sheets/detail/human-papillomavirus-(hpv)-and-cervical-cancer. Last updated November 11, 2020. Accessed December 18, 2020.
10. Wright TC et al. Gynecol Oncol. 2019;153(2):259-265.
11. Drolet M et al. Lancet.2019;394(10197): 497-509.
12. Monsonego J et al. Gynecol Oncol. 2015;10:1016.
13. Schiffman M et al. Gynecol Oncol. 2015;138(3):573-578.
14. Schiffman M et al. Int J Cancer. 2016:139:2606-2615.
15. Schiffman M et al. J Clin Microbiol. 2015;53(1):52-59.
16. Bonde JH et al. J Low Genit Tract Dis. 2020;24(1):1-13.
