there is a less painful way to diagnose cervical cancer – NiT

Goodbye Pap smears: There’s a less painful way to diagnose cervical cancer

The end of the uncomfortable (and embarrassing) gynecological exam used to detect HPV may be closer.

Alternative seen as added value.

No woman likes having to go through those days of the month. However, the boring logistics that no one appreciates, of having to use menstrual pads, may, after all, prove to be an asset in preventing a serious consequence of the most common sexually transmitted infection in the world.

The analysis of sanitary towels used during menstruation may replace the uncomfortable screening test for a virus contracted by 80 percent of sexually active women at some point in their lives, HPV.

Human papillomavirus (HPV) is responsible for a high number of infections that, in most cases, do not present symptoms and are spontaneously regressed. These infections can cause damage to the female reproductive organs that can progress, in more severe cases, to cervical cancer. The standard diagnostic test for this infection is called cytology, better known as Pap smear. During the procedure, performed vaginally and using instruments, the doctor collects tissue from the cervix which is then analyzed in the laboratory to rule out the possible presence of the virus and/or precancerous cells.

This is not, at all, a situation taken lightly by most women who must undergo this exam annually, between the ages of 25 and 60. However, scientific research has good news: the end of this uncomfortable (and for many, embarrassing) routine HPV test may be closer.

Analyzes of blood collected in sanitary towels made it possible to identify cells infected by the various subtypes of the human papilloma virus. The experience was tested and confirmed within the framework of a study carried out in China and published in December 2021 in the journal “JAMA Network Open”.

Using common sanitary towels from 120 HPV-infected patients between September 2020 and April 2021, Professor Jingjing Zhang and his team were able to identify with 94.2 percent accuracy the presence of infected cells in the analyzed blood.

The researchers involved in the discovery explained that they collected the menstrual pads for analysis on the second day of menstruation. This is because, normally, when a greater intensity of menstrual flow is observed, allowing more blood samples to be collected, which allow a greater number of tests to be performed.

In addition to being easier, more practical and completely painless to detect the presence of HPV, the research also concluded that the analysis performed on the blood collected in the dressings allowed to detect more subtypes of the virus with precision.. An asset in screening for infections and cervical cancer, says gynecologist Fernando Cirurgião. “Cytology only allows us to perceive the presence of the virus and not determine its subtype”, he explains.

The clinician says that this discovery represents a big step not only for gynecology, but especially for women. “Most of the patients still feel embarrassed when they have to do a cytology, so this method would be an important innovation in that sense.” And it has other advantages, explains the specialist: “In some cultures, it can be seen as more positive than a Pap smear, which implies that the patient is observed by a health professional”.

The gynecologist also adds that this method would make it possible to perform a universal screening, something that currently does not happen. If this type of generalized screening existed, it would allow an earlier detection of HPV infections, prevent the development of cervical cancer in a more sustained way and would also help to deepen research on the disease.

However, it leaves a warning: “Many women, believing in unfounded myths related to the reproductive system and the role of routine exams in gynecological health, avoid performing these procedures”. The positive results that this type of non-invasive analysis can obtain will only have a real impact if “there is a concern to launch a strong information and communication campaign” about their need.

What causes cervical cancer?

This oncological disease is caused by the human papillomavirus virus, HPV. However, contracting an infection caused by this viral agent, by itself, does not mean that a woman will develop cancer. There are other factors that can contribute to the lesions caused by the virus to evolve in this direction, such as tobacco and the functioning of the immune system.

There are more than 120 different types of HPV, some are considered high risk and others low risk. About 40 mainly affect the genitals (vulva, vagina, cervix, penis and anus). The most common high-risk variants are 16 and 18, which account for 75 percent of lesions that become cancerous.

The remaining subtypes are considered low risk, because although they also cause lesions in the mucous membranes, they tend not to develop cancer cells. That is, the probability of developing cancer is strongly related to the subtype of the virus responsible for the infection. Screening thus allows for a more effective detection of the same and the treatment of existing precancerous lesions.

In Portugal, there is a screening program for all women between 25 and 60 years old and it is based on a cytology and carrying out an HPV investigation in the laboratory on the collected tissues. If the test is negative, it only needs to be repeated after five years. In addition, there is a vaccine that has been part of the national vaccination plan since 2008. Even so, Fernando Cirurgião reinforces: “Even inoculated women must participate in screenings, because the vaccine, although increasingly effective, only prevents the infection”.