23 December 2008 : New evidence from the ALTS trial suggests that 40% of CIN 2 will regress over 2 years, but CIN 2 caused by HPV-16 may be less likely to regress than CIN 2 caused by other high-risk-HPV genotypes.
http://ppv.ovid.com/pt/re/ppv/abstract.00006250-200901000-00006.htmjsessionid=JRxFybLNMtW2...
22 December 2008 : Currently in the US less than 25 percent of the target population has received an HPV vaccination, far below the target needed to maximize the vaccine’s potential public health benefit.
A study from Yale University reports that parental concerns about increased promiscuity were the single biggest factor in the decision–making process. Financial considerations also influences people’s choices.
“A fundamental but often–neglected aspect of developing and implementing an optimal intervention program is human psychology which influences adherence to recommendations,” said Alison Galvani, Assistant Professor in Epidemiology of Microbial Diseases
http://info.med.yale.edu/eph/news/nov08/hpv_25nov08.html
19 December 2008 : Quote from the report of the second phase of the Independent review of NHS Pathology services in England:
"84. In the past one of the strengths of the NHS has been the interrelationship between service provision and research. For example, the use of human biological samples, collected via the pathology laboratory, has been central to the success of much experimental medicine (itself a priority area within health). With a growing focus on service delivery, and in a more cost-conscious culture, there is evidence that the scope for researchers to gain access to such material via the pathology laboratory is becoming more difficult.
85. Such a trend is not in the long-term interests of the NHS – or of patients. We support those who wish to see research embedded into the new ways of working. We welcome the proposal to set up a working group to foster the contribution of pathology services to research. This is an issue that extends beyond pathology but in consolidating pathology services it is essential to build in measures that facilitate translational research."
The endorsement from the Royal College of Pathologists reads:
"The College aims to advance the science and practice of pathology for the benefit of the public to provide public education, to promote research in pathology and to disseminate the results."
09 December 2008 : After more than 380,000 HPV vaccine doses given in Australian schools since 2007, only three schoolgirls were found to have probable hypersensitivity to the quadrivalent vaccine, Gardasil. Read the full paper for free in this week''s BMJ.
http://www.bmj.com/cgi/content/full/337/dec02_2/a2642
05 December 2008 : A fascinating insight into the link between social deprivation and cancer in England:
"Overall it is estimated that if the entire population had the incidence rates of the least deprived quintile, there would be approximately 14,300 fewer cancers each year". David Forman, Information and Analysis Lead, NCIN.
Social deprivation doubles the risk of cervical cancer
http://www.ncin.org.uk/index_files/analysis.htm
04 December 2008 : Results of three statistical models presented at the European Research Organisation on Genital Infection and Neoplasia (EUROGIN) annual meeting suggest that women vaccinated with the HPV vaccine Cervarix could look forward to a prolonged immune response against hpv 16 and 18 for at least 20 years.
http://www.medicalnewstoday.com/articles/129457.php
29 November 2008 : HPV prevalence data are needed for two reasons: assessment of the impact of prophylactic HPV vaccination and to help inform future screening strategies. This research provides such data for the South Wales area. Curiously, HPV type 31 is more common than type 18 in this part of the world.
http://www.ncbi.nlm.nih.gov/pubmed/19034285?dopt=AbstractPlus
14 November 2008 : Cytologists have long pondered the potential use of cytology for the early diagnosis of oral cancer. However, oral cytology has always suffered from poor sensitivity and specificity, largely because of the difficulty in obtained adequate specimens. Interest has recently been revived due to the introduction of a cytobrush for cell collection as well as a computer-assisted analysis (Oral CDx®). as described in this review paper in the Journal of Oral Pathology & Medicine.
http://www3.interscience.wiley.com/journal/121497010/abstract
27 October 2008 : Automated detection of genetic abnormalities combined with sputum cytology is a sensitive predictor of lung cancer, according to a study reported in the journal Modern Pathology.
A combination of cytological atypia and genetic abnormalities for 3p22.1 and 10q22.3 (detected by fluorescence in situ hybridisation) achieved 74% sensitivity and 82% specificity, compared with only 37% sensitivity and 87% specificity when cytology alone was used.
http://www.ncbi.nlm.nih.gov/pubmed/18500269
26 October 2008 : A pilot study reported in the journal Radiology has shown that a new imaging technology (diffusion-weighted magnetic resonance imaging) can identify small cervical tumours, reducing the need for radical surgery in Stage Ia and Ib1 Disease.
http://radiology.rsnajnls.org/cgi/content/abstract/249/2/541
26 October 2008 : Combining cytology with HPV testing improves the sensitivity of screening, but how often does it need to be repeated? A European study in the BMJ suggests that 6 years is probably a safe interval, and that HPV testing alone may suffice. Among ~25,000 women tested in 6 countries, the rate of CIN3+ at 6 years was only 0.27% in those who were HPV-negative at baseline compared with 0.97% in those who were cytology-negative. Combining the two tests made little difference.
http://www.bmj.com/cgi/content/full/337/oct13_1/a1754
17 October 2008 : The number of cells required for LBC samples to be deemed adequate remains the subject of debate. There is a risk that samples may be described as negative when they are really inadequate and that abnormalities could therefore be missed.
An adequate LBC sample is one in which sufficient numbers of cells are present to allow the detection of an abnormality were it to be present. This study aims to establish the threshold of cellularity which will minimise the risk of false negative reports.
http://www.hta.ac.uk/project/1600.asp?src=rss
07 October 2008 : That''s the conclusion from a substudy of the NTCC HPV screening trial in this week''s The Lancet Oncology.
It is accepted that HPV testing lacks the specificity of cytology, leading some to suggest that HPV screening and cytology triage provides the best combination of sensitivity and specificity for cervical screening.
This study puts the cat among the pigeons by suggesting that p16 triage following a positive test for high risk HPV might be the best combination, apparently leaving no place for cytology.
http://www.thelancet.com/journals/lanonc/article/PIIS1470204508702080/abstract
Jonah Jones is a designer, programmer, film maker and photographer who specialises in the internet and usability. Jonah Jones