Q: How have you performed cervical cancer screenings in the past?
A: Typically, I've used a ThinPrep® Pap test. And according to the latest guidelines, I've performed HPV testing along with the Pap test every three years for patients ages 30 to 65. In July 2012, we started performing the cobas® HPV Test, which gives us individual genotype 16 and 18 results, for all of our patients over 21 with ASC-US Pap results or patients ages 30 to 65.
Q: How has the cobas® HPV Test changed the way you care for patients?
A: The biggest change for me is seeing how sensitive the cobas® HPV Test is and the detailed information that it provides me with, especially in terms of identifying the 16 and 18 genotypes, the highest risk types of HPV. For patients that have a Pap test that is negative for abnormal changes, but a positive result from the cobas® HPV Test, I'm able to take better care of them and treat them now with colposcopy as opposed to repeating a Pap test in 12 months.
Q: What is the value of knowing more about a patient's cervical cancer risk?
A: When you have a better sense of a patient's cervical cancer risk, you can plan for how closely to watch her. If a patient has received negative results from the cobas® HPV Test, I feel more comfortable knowing that she is less likely to have cervical disease or develop it over the next three years. But if she is positive for HPV 16 or HPV 18, I will watch her more closely and be more diligent in my examinations with her.
Q: As the only FDA-approved assay that provides pooled results for high-risk HPV genotypes and individual results for HPV 16 and 18 in one test, how has the cobas® HPV Test changed the way you diagnose and treat women?
A: Having access to a test with clinically relevant sensitivity and accuracy changes the way you care for all of your patients, allowing you to reassure patients who have negative Pap and HPV test results, or to better assess the risk of patients who are positive for one or several types of HPV. I started using the cobas® HPV Test in July 2012, and I've had two patients who had normal Pap results in the past but were positive for HPV 18 with the cobas® HPV Test. I performed a colposcopy on both patients and found a four-quadrant lesion with moderate dysplasia in one of the women and adenocarcinoma of the cervix in the other. Both underwent appropriate treatments, a LEEP procedure and a hysterectomy. But had I not performed the cobas® HPV Test on these women, they probably wouldn't have returned until the following year for a routine Pap test, and their cervical disease could have become much more severe or life-threatening.
Q: In what other ways has the cobas® HPV Test provided value to your practice and your patients?
A: In addition to clinically relevant sensitivity and accuracy, the cobas® HPV Test provides a better tool to help me counsel patients. I've had quite a few patients who want to know which HPV genotype they have and what their risk is. Before the cobas® HPV Test, I wasn't able to tell a patient which of the high-risk types they were positive for and what their exact risk was. Now, I'm able to tell a patient whether she has the most oncogenic types of HPV, what her risk is for developing cervical disease, and what our plan will be to make sure she gets the best care possible. And since the cobas® HPV Test is about the same price as most other HPV tests on the market, we're getting a lot more useful information about our patients without an increase in cost.
Dr. Moore 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.
Women’s Health Specialists Murfreesboro, TN