HARTFORD, Conn.--(BUSINESS WIRE)--Internationally recognized American pathologist Sin Hang Lee, MD, in a recent keynote address told conference attendees that Pap smear cytopathologists should review DNA sequencing for HPV genotyping “in a similar way that cardiologists use EKG.” Doing so, he said, would result in a “revolutionary improvement in increased diagnostic accuracy for physicians and patients.”
Pap smear cytopathologists must begin practicing evidence-based medicine for cervical cancer prevention in this era of molecular personalized medicine, Dr. Lee said in a speech entitled “Turn Cytopathology’s Crisis into Opportunity” at the International Cytopathology Conference in Toronto on August 31, 2015.
Dr. Lee told attendees that each positive human papillomavirus (HPV) test report should be accompanied by a signature DNA sequence fully matched with a GenBank standard sequence as the physical evidence, “like the EKG in a cardiologist’s report,” to confirm the genotype of the virus detected. DNA sequencing is the gold standard for HPV genotyping.
Only persistent infection evidenced by finding the same HPV genotype in repeated cervical samples is associated with cancer risk. However, said Dr. Lee, an extremely sensitive HPV test is needed to reduce the chance of false negative results if an HPV test is relied upon for cervical cancer detection. The PowerPoint slides of Dr. Lee’s presentation are posted for public viewing on the website of Milford Molecular Diagnostics: http://dnalymetest.com/images/Cytopath_Keynote_2015_-_SHLee.pdf .
Dr. Lee also advised that when a Pap smear shows a high-grade squamous intraepithelial lesion (HSIL), the report must contain a copy of the microphotograph image of the premalignant cells as physical evidence based on which a cytopathologist’s diagnosis is made because Pap smear cytology classification is highly subjective and not always reproducible.
Cytopathology is a profession created to implement Pap smear as a screening tool for cervical cancer prevention with great success. But DNA testing is found to be much more sensitive in detecting HPV infection, a necessary factor in the pathologic process which may lead to cervical cancer development in a very small fraction of HPV-infected patients. Most HPV infections are cleared spontaneously within one year. Referring all one-time HPV-positive women without Pap smear cytology to colposcopic biopsy is causing too many unnecessary, traumatic and harmful procedures on women at great cost to society, said Dr. Lee.
“Pap smear cytology is more accurate in distinguishing a premalignant or malignant process from other benign conditions and cannot be replaced by HPV tests as suggested by some experts working as consultants to the HPV industry,” said Dr. Lee.
Dr. Lee is the director of Milford Molecular Diagnostics laboratory. He has developed the extremely sensitive and reliable DNA sequencing-based HPV genotyping tests for cervical screening. This technology is now being used for molecular diagnosis of Lyme disease and related borreliosis. The website is www.dnalymetest.com