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Study: New cervical cancer test improves detection

Rating

4 Star

Study: New cervical cancer test improves detection

Our Review Summary

HPV infection is responsible for 99% of the incidence of cervical cancer. Theoretically, screening for HPV DNA could replace Pap smears as the preferred method for cervical cancer screening. However, because HPV infection is so common and only a small percentage of women with HPV will go on to develop cellular changes that could lead to cervical cancer, it is still uncertain whether the increase in indentified cases is worth the additional cost of the test. This story reports on the publication of two large international studies in this week’s New England Journal of Medicine.

The story adequately represents the availability, novelty, alternative options and cost of the HPV test. By not exagerrating the seriousness or prevalence of cervical cancer, the story avoids disease mongering. The story rightly points out the declining mortality rate since the introduction of screening.

The story also does a good job of describing the strength of the available evidence. Most notably, the story points out that neither study evaluated whether the testing resulted in increased life expectancy in those screened and that the applicability of the results to the U.S. is somewhat questionable.

However, the story only quotes one independent expert. Although that person provides very valuable information, the story should have quoted at least one other expert who could have commented on the importance of these new findings on clinical practice. Finally, the story does not adequately quantify the benefits of HPV testing. Although the story says that the test combined with Pap found 51% more cancers than Pap alone, this is not adequate quantification. The story should have provided quantitative information in absolute rather than relative terms.

 

Criteria

Does the story adequately discuss the costs of the intervention?

Satisfactory

The story does mention that the test costs $50 compared to $20 to $30 for the pap test. The story could have discussed insurance coverage for the test and also potential downstream costs due to the higher false positive rate of the test.

Does the story adequately quantify the benefits of the treatment/test/product/procedure?

Not Satisfactory

The story does not adequately quantify the benefits of HPV testing. Although the story says that the test combined with Pap found 51% more cancers than Pap alone, this is not adequate quantification. The story should have provided quantitative information in absolute rather than relative terms.

Does the story adequately explain/quantify the harms of the intervention?

Satisfactory

The story mentions a major downside of HPV testing is that it catches transient HPV infections that resolve on their own and never cause a problem.

Does the story seem to grasp the quality of the evidence?

Satisfactory

The story adequately describes the strength of the available evidence. Most notably, the story points out that neither study evaluated whether the testing resulted in increased life expectancy in those screened and that the applicability of the results to the U.S. is somewhat questionable.

Does the story commit disease-mongering?

Satisfactory

The story does not exagerrate the seriousness or prevalence of cervical cancer. The story rightly points out the declining mortality rate since the introduction of screening.

Does the story use independent sources and identify conflicts of interest?

Not Satisfactory

The story only quotes one expert and that is the author of an editorial in the same journal where the study appeared. Although that expert does provide very valuable information, the story should have quoted at least one other expert who could have commented on the importance of these new findings on clinical practice.

Does the story compare the new approach with existing alternatives?

Satisfactory

The story does mention the Pap test as the alternative to the HPV test and discusses the pros and cons of each.

Does the story establish the availability of the treatment/test/product/procedure?

Satisfactory

The story does state that the test has been FDA approved since 2003.

Does the story establish the true novelty of the approach?

Satisfactory

The story clearly states that the HPV test is relatively new.

Does the story appear to rely solely or largely on a news release?

Not Applicable

There is no way to know whether the story relied on a press release as the sole source of information.

Total Score: 7 of 9 Satisfactory

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