Molecular Test Improves Evaluation of Cervical Cancer Risk

A new laboratory test identifies molecular changes to cervical cells that increase the likelihood that a woman may develop cervical cancer.

The new test is designed to help physicians identify women who are at increased risk of developing malignancy, unless treated, after receiving unclear results for cervical cancer risk from standard screening tests.

The Quest Diagnostics (Madison, NJ, USA) cervical cancer TERC test is based on the human telomerase RNA component (TERC) gene marker under a nonexclusive patent license from the National Institutes of Health (NIH; Bethesda, MD, USA). Research by NIH has shown that the TERC gene is amplified, indicated by an abnormal number of copies of the gene on chromosome arm 3q, in the precursor cells of cervical cancer, and therefore may be useful for risk stratification in Papanicolaou (Pap) screening.

In the United States, women are screened for cervical cancer using Pap and/or Human papillomavirus (HPV) tests. Neither Pap nor HPV tests provide definitive results for risk for cervical cancer. Pap tests identify and categorize cellular changes according to the risk they will become malignant. HPV tests identify infection with HPV, a virus that causes cervical cancer in some women but is cleared by the immune system in others.

The new Quest Diagnostics test is designed as an adjunct to conventional Pap and HPV tests, and is performed on residual samples from Pap tests. It detects abnormal changes to the TERC gene and chromosome 3 to provide a risk assessment of progression to cervical cancer in women who receive indeterminate Pap and/or HPV test results. Women with the highest risk result may benefit from additional cervical biopsies at colposcopy and more aggressive monitoring and treatment, while women with low-risk TERC and HPV results may be less likely to undergo unnecessary follow-up colposcopy and other procedures.

In early 2012, Quest Diagnostics began to offer testing services to identify E6/E7 messenger RNA to help physicians identify women infected with HPV who may have a significantly increased risk of cervical cancer.

"Given that medical guidelines now advise less frequent cervical cancer screening for women, it is more important than ever that testing for this cancer be highly reliable," said Daniel M. Jones, MD, PhD, medical director, cancer diagnostics services, Quest Diagnostics. "Testing for abnormalities of the TERC gene is based on the most advanced scientific knowledge available of the molecular changes that turn cervical dysplasia into malignancy. It can potentially act like a 'second opinion' for the thousands of women whose Pap and HPV test results produce an indeterminate picture of cancer risk each year."

"One of NIH's goals is to collaborate with commercial organizations to transform our scientific discoveries into clinically valuable technologies," said Dr. Mark Rohrbaugh, director of the office of technology transfer at the NIH. "The widespread availability of the TERC test through Quest Diagnostics achieves this goal because it has the potential to improve the prediction of cervical cancer risk for many women. It highlights the potential for successful public-private collaborations to advance the practice of medicine."

Related Links:
Quest Diagnostics
National Institutes of Health