NCCN updates cervical cancer guidelines for women with positive DNA test results, negative screen

The National Comprehensive Cancer Network recently updated its Clinical Practice Guidelines for Cervical Cancer Screening with a new section of recommendations for women who have positive results on the HPV high-risk DNA test but negative cervical cytology screen or Pap smears.

The new section recommends two options for women aged 30 years and older who receive a positive HPV high-risk DNA result and negative screen: undergo the more specific HPV 16/18 DNA test or undergo a colposcopy, which is the primary method for evaluating women with abnormal cervical cytology.

In March, the FDA approved two new diagnostic HPV DNA tests — the Cervista HPV High-Risk DNA test (Third Wave Technologies, Hologic), which determines whether any of the 14 oncogenic HPV types are present, and the Cervista HPV 16/18 DNA test that determines whether HPV-16 and/or HPV-18 are present.

Currently, the NCCN guidelines recommend that HPV DNA testing complement cervical cancer screening methods, not replace them. The guidelines note, however, that HPV DNA testing is not recommended for women younger than 21.

The NCCN guidelines, which are developed and updated through an evidence-based process with expert review of current research and judgment from a multidisciplinary panel of physicians, also provide screening recommendations for women who have received the HPV vaccine, which protects against HPV types 6, 11, 16 and 18. The guidelines state that women who have been vaccinated remain at risk for less common types of HPV and should continue to be screened.