HIQA to identify the most effective screening method for the prevention of cervical cancer

Tuesday 2 February 2016: The Health Information and Quality Authority (HIQA) is to conduct research to determine the optimum primary screening test for the prevention of cervical cancer in Ireland.

At the request of the National Screening Service, HIQA will undertake a health technology assessment (HTA) to independently evaluate the clinical, financial, ethical and organisational implications of establishing human papillomavirus (HPV) testing as the primary screening test for preventing cervical cancer. At present, liquid-based cytology is used as the primary screening tool by the National Cervical Screening Programme (CervicalCheck).

If low grade abnormalities are detected, the same sample is tested for HPV DNA to determine if the woman should be referred for colposcopy or back to routine screening. Changing the order of these tests, that is, using HPV DNA testing as the primary test followed by liquid-based cytology, has the potential to improve the detection of cancerous and pre-cancerous cell changes and to increase the efficiency of the screening process.

HIQA’s Director of Health Technology Assessment Dr Máirín Ryan said: "By examining international evidence on the clinical and cost-effectiveness of HPV testing — and by modelling these benefits, along with the budget impact of switching to HPV DNA testing for the Irish healthcare system - we will be in a position to provide independent advice on the optimal screening strategy for preventing cervical cancer in Ireland."

HPV is a common virus usually spread by skin-to-skin contact during sexual contact. Most people will have HPV at some point in their lives, and in most cases it causes no symptoms and is cleared by the body’s immune system. However, persistent infection with a number of HPV virus types can lead to the development of cervical cancer.

An expert advisory group (EAG) comprising key stakeholder groups is currently being formed and will advise the HTA evaluation team during the course of this assessment.

The final results of the HTA are expected at the end of the year and will be submitted to the National Screening Service for consideration.

The Terms of Reference of the HTA are to:

• describe the epidemiology of cervical cancer and human papillomavirus in Ireland.
• examine the current evidence of efficacy and safety for human papillomavirus testing as a primary screening method for the prevention of cervical cancer.
• review the international cost-effectiveness literature of human papillomavirus testing as a primary screening method for the prevention of cervical cancer.
• estimate the clinical implications and cost-effectiveness of human papillomavirus testing as a primary screening test for the prevention of cervical cancer, including potential changes to the screening interval, age ranges and test sequencing compared with the current programme of liquid based cytology screening.
• estimate the resource implications and budget impact of human papillomavirus testing as a primary screening test for the prevention ofcervical cancer.
• consider any wider ethical or societal implications that human papillomavirus testing as a primary screening test for the prevention of cervical cancer may have for patients, the general public or the healthcare system.
• based on this assessment, advise on the optimal screening strategy for the prevention of cervical cancer.

 

For further information please contact:
Marty Whelan, Head of Communications and Stakeholder Engagement, HIQA
01 814 7480 / 086 2447 623 mwhelan@hiqa.ie

 

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