New research
supports
co-testing

Latest 2020 study confirms that co-testing with Pap and HPV together identifies more cases of cancer and precancer1

A recent Quest Diagnostics Health Trends retrospective, longitudinal study confirms the value of co-testing in women ages 30 to 65.

cervical cancers were identified with co-testing <12 months to diagnosis1

22.5% of cancers would not have been identified with HPV alone1

Data <12 months of cancer diagnosis

precancers were identified with co-testing <12 months to diagnosis1

11% of precancers would not have been indentified with Pap alone1

Data <12 months of precancer diagnosis

Cancer outcomes over the entire study period (9 years)

Co-testing with Pap and HPV together identified more cases of cancer than either test alone1

Adenocarcinoma (ADC) is on the rise.2 HPV alone and Pap alone failed to identify more than twice as many women diagnosed with ADC as co-testing1

Real-world comparisons confirm the benefit of co-testing

The Quest Diagnostics Health Trends data analysis includes a highly diverse, heterogeneous population representative of the US population. It’s also a longitudinal study that includes multiple cervical cancer screening results per patient. This real-world study is more relevant to drive decisions about cervical cancer screening algorithms than data that includes a microcosm of patients.

  Quest Diagnostics Health Trends
Am J Clin Pathol. 20201
Am J Clin Pathol. 20183 J Natl Cancer Inst. 20184
  NATIONAL REFERENCE LABORATORY LARGE ACADEMIC MEDICAL CENTER REGIONAL LABORATORY AND INTEGRATED DELIVERY NETWORK
Study period 9 years
(2010 – 2018)
12+ years
(2005 – 2017)
13 years
(2003 - 2015)
Large screening population 13.6M women 270K women 1.2M women
Cervical cancer cases 1,259 129 623
Cytology: liquid-based cytology (LBC) only ThinPrep® & SurePath ThinPrep® image-guided Conventional cytology used until 2009 SurePath after 20093,5
Longitudinal study
Data reflects the real-world, opportunistic screening of US population
% of cancers detected overall by cotesting 86.9% co-test 89.4% co-test 82.6% co-test

Visit WhyCotesting.com to review the
Quest Diagnostics Health Trends study

 

PREVIOUS STUDIES

A separate 2018 study confirms the value of co-testing

An additional, real-world longitudinal data analysis of 186,000 women between the ages of 30 and 65 also found that there is a significantly lower chance of getting a false negative for invasive cervical cancer and precancer with co-testing.3

For the time period of 12 months or more before a diagnosis of cervical cancer:

more women would not have been identified with HPV-alone testing3
more women would not have been identified with Pap-alone testing versus co-testing3

False-negative screening results for invasive cervical cancer

For the time period of 12 months or more before a diagnosis of CIN3+/AIS:a

more women would not have been identified with HPV-alone testing3
more women would not have been identified with Pap-alone testing versus co-testing3

False-negative screening results for CIN3+/AIS

Now more than ever, co-testing makes a difference

  1. Screening intervals have increased over time

  2. Depending on the patient’s age and the guidelines, intervals include:5

    Pap alone
    every 3 years

    Co-testing
    every 5 years

    OR

    HPV alone
    testing every 3 or 5 years

  3. In most cases in the US, cervical cancer screening is opportunistic rather than routine1,4

Guidelines continue to support co-testing in women ages 30–655,6

Quest Health Trends data is relevant to the development of cervical cancer screening guidelines and pertinent to your day-to-day patient care1

Test ordering information

Ordering cervical cancer screening is efficient using one-click Smart Codes. For more information or a complete list of our tests, visit our test directory.

a CIN3 = cervical intraepithelial neoplasia 3; AIS = adenocarcinoma in situ

References
  1. Kaufman HW, Alagia DP, Chen Z, Onisko A, Austin RM. Contributions of liquid-based (Papanicolaou) cytology and human papillomavirus testing in co-testing for detection of cervical cancer and precancer in the United States. Am J Clin Pathol.
    Published online ahead of print. July 8, 2020. doi:10.1093/ajcp/aqaa074
  2. Adegoke O, Kulasingam S, Virnig B. Cervical cancer trends in the United States: a 35-year population-based analysis. J Woman’s Health (Larchmt). 2012;21(10):1031-1037. doi:10.1089/jwh.2011.3385
  3. Austin RM, Onisko A, Zhao C. Enhanced detection of cervical cancer and precancer through use of imaged liquid-based cytology in routine cytology and HPV cotesting. Am J Clin Pathol. 2018;150(5):385-392. doi:10.1093/ajcp/aqy114
  4. Schiffman M, Kinney WK, Cheung LC, et al. Relative performance of HPV and cytology components of cotesting in cervical screening. J Natl Cancer Inst. 2018;110(5):501-508. doi:10.1093/jnci/djx225
  5. US Preventive Services Task Force. Final recommendation statement. Cervical cancer: screening. Updated August 2018. Accessed July 2020. https://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementFinal/cervical-cancer-screening2
  6. American College of Obstetricians and Gynecologists. Practice advisory: cervical cancer screening (update). Published August 21, 2018. Accessed November 8, 2019. https://www.acog.org/clinical/clinical-guidance/practice-advisory/articles/2018/08/cervical-cancer-screening-update