Scientists at the Montefiore Einstein Cancer Center have developed a breakthrough test that can detect a type of cervical cancer missed by traditional Pap smears. The test, described in the Journal of the National Cancer Institute, shows promise in detecting cervical adenocarcinoma (ADC) and its precursor lesions, adenocarcinoma in situ (AIS), which often progress to ADC.
Cervical adenocarcinoma accounts for up to 25% of cervical cancer cases but is often not effectively detected by current screening methods like the Pap smear. This lack of detection leads to higher mortality rates compared to the more common squamous cell cancer. The goal of the new test is to catch the disease early, before it develops into cancer.
While the Pap smear has significantly reduced the incidence of squamous cell cancer, the incidence of ADC has remained unaffected due to the test’s limited effectiveness in detecting it. In recent years, testing for human papillomaviruses (HPVs) has become a standard screening tool alongside the Pap smear. However, the current HPV tests still struggle to detect ADC cases.
The Montefiore Einstein Cancer Center’s novel HPV test takes a different approach by assessing methylation levels in specific viral-genome sites. Methylation, the addition of methyl groups to DNA, plays a crucial role in gene expression. By analyzing methylation levels in cervical tissue samples, the researchers identified a high correlation between elevated methylation scores and the presence of ADC or AIS.
The findings of this study suggest that women with a high methylation score could benefit from specialized tissue evaluation and colposcopy, which could lead to early diagnosis and treatment of ADC or the removal of AIS lesions before they progress. This could significantly improve cervical cancer screening, particularly in lower-resourced countries where the test’s simplified equipment could be utilized.
Cervical cancer remains the fourth most common type of cancer among women, and its burden is highest in lower- and middle-income countries. The Montefiore Einstein Cancer Center’s HPV methylation test has the potential to increase screening equity in the United States and globally. Ideally, this test would only need to be done once every three to five years, making it more accessible and convenient for women.
Further clinical trials are needed to confirm the efficacy of the HPV methylation test. If successful, it could revolutionize cervical cancer screening and improve early detection rates for ADC and AIS. With continued advancements in testing technologies, researchers are hopeful that they can make significant strides in reducing the impact of cervical cancer worldwide.
