Q: How have you performed cervical cancer screening in the past?
A: In the past, I've used a Pap test with liquid medium, along with HPV screening on women with abnormal Pap results or women 30 to 65 years old. With these approaches, we knew they were positive for a high-risk type from a pooled result, but we didn't know their exact risk for the most oncogenic types of HPV,
16 and 18.
Q: How has the cobas® HPV Test changed the way you care for patients?
A: The major change has been that the cobas® HPV Test has given me the ability to identify the highest-risk types of HPV, genotypes 16 and 18. This has simplified the screening process for me and my patients and has helped me to better identify and understand a patient's particular risk and assess when it is necessary to perform a colposcopy. In the past, we'd often have inconclusive results and would have to wait to perform a follow-up Pap test the next year before we were really able to see those abnormal changes in the patient's cells.
Q: What is the value of knowing more about a patient's cervical cancer risk?
A: The value comes from being able to follow a patient more closely when you know her precise risk and perform early evaluation or treatment to prevent the patient from developing a more severe disease. Some of these patients will have CIN2 or CIN3 that could put them at risk for cervical disease. With the information provided by the cobas® HPV Test, we can identify patients at high risk and perform a colposcopy and treatment, if necessary, before more aggressive treatment is required.
Q: Why is it important to you to avoid excessive analytic sensitivity and cross-reactivity with low-risk genotypes in an HPV test?
A: The fact that the cobas® HPV Test does not have excessive analytic sensitivity or cross-reactivity with low-risk genotypes contributes to its accuracy, specifically in its ability to correctly identify and provide individual results for HPV 16 and 18, the two genotypes of most concern. This minimizes inconclusive results and I get precise and rapid results on which to base my treatment decisions.
Q: Do you have concerns about sample size and potential false negatives from an HPV test?
A: False negatives are always a concern. When we work with labs using tests other than the cobas® HPV Test, about ten percent of our samples are returned every day due to insufficient sample size. There is a disclaimer that says the tests may not get an accurate reading if the sample size is not large enough, which could lead to false negatives. I haven't had any of these issues with the cobas® HPV Test. This saves my employees time and saves us from having to call a patient back for additional testing or evaluation when it's not needed.
Q: Why is it important to have an internal cellular control for your HPV test?
A: It's very valuable to me because it helps ensure that a result isn't a false negative. The cobas® HPV Test monitors cellular material to reduce the risk of a false negative result. So if I do want to follow up with the pathologist to discuss his or her findings, I have a lot more assurance up front. The internal cellular control of the cobas® HPV Test gives me confidence in the accuracy of the results.
Dr. Ortman-Nabi serves as a paid speaker with the Roche Diagnostics Clinician Speakers Bureau and was compensated for her testimonial. The information presented in this interview represents the opinions and medical decisions of the individual healthcare practitioner and is not intended to be a treatment recommendation by Roche Diagnostics or to serve as a substitute for the professional medical judgment of healthcare practitioners in the management or treatment of their patients.
All Care for Women Amherst, NY