Cervical cancer remains a major public health challenge. According to the International Agency for Research on Cancer, 604,000 new cases were diagnosed and 342,000 people died from cervical cancer in 2020. In high-income countries, screening with cytology and high-risk human papillomavirus (HPV) DNA testing has decreased the level of cervical cancer mortality. But in low- and middle-income countries, the burden of cervical cancer remains constant, due to the lack of established screening programmes.
To mitigate this shortfall, a team headed up by Rice University professor Rebecca Richards-Kortum – in collaboration with researchers from the National Cancer Institute, the Mozambique Ministry of Health, Baylor College of Medicine and the MD Anderson Cancer Center – has developed an innovative, low-cost point-of-care DNA test for HPV infections. This breakthrough test could revolutionize cervical cancer screening in low- and middle-income countries.
HPV is a group of viruses that commonly infect individuals without causing any symptoms. However, persistent infections with certain HPV types can lead to cervical cancer, which is a preventable and treatable condition if detected early.
The novel testing platform, reported in Science Translational Medicine, combines isothermal DNA amplification and lateral flow detection technologies. The researchers unveiled a streamlined six-step HPV test capable of detecting HPV16 and HPV18 – the viruses responsible for about 70% of cervical cancer cases.
The cost-effective test produces results within 45 minutes, using only two pieces of equipment. One of these instruments, a readily available minicentrifuge priced at approximately $500, is supplemented by a specialized dual-chamber heater named NATflow, with a similar price. The NATflow set-up employs disposable cartridges designed to prevent false positives stemming from workspace contamination by amplified DNA, a common challenge in point-of-care molecular testing.
Routine screening has proved effective in identifying precancerous lesions and early-stage cervical cancer, thereby significantly reducing the likelihood of disease progression. However, individuals who have never been screened or lack regular screenings remain at higher risk. The new testing platform addresses these challenges.
The simplicity of the test and its affordability offer potential to democratize screening processes and empower women who have previously lacked access to critical healthcare services. The ability to combine testing, diagnosis and potential treatment in a single visit, even in resource-limited settings such as small clinics or mobile diagnostic units, could mark a turning point in global efforts to eliminate cervical cancer.
Personalized approach improves cervical cancer treatment
The researchers predict that each test will cost below $5. This affordability, and the adaptability of the developed platform, hold potential beyond cervical cancer screening. The researchers envision the platform’s use in DNA tests for other type of HPV with the groundbreaking contamination-prevention measures making it an attractive option for widespread implementation.
While the HPV test is not yet ready for widespread use, as further modifications are needed to detect additional cancer-causing HPV types and additional field testing is required, the researchers are committed to advancing its development. The collaboration between academic and medical institutions, combined with technological innovations, offers a glimmer of hope for a future where cervical cancer is significantly reduced, particularly in regions where access to healthcare has historically been limited.
