The trial included 28,000 women over 30 years old who attended their cervical screening test in Stockholm between January and March 2017. The researchers, led by Prof Martin Widschwendter at the University of Innsbruck and the Karolinska Institutet, ran all of the 2,377 HPV positive samples through the WID-qCIN test and compared it against the current test (called cytology). The WID-qCIN test, when combined with HPV type 16/18 test (a test for two types of high-risk HPV), picked up all cervical cancers and 93% of abnormal cell changes which could develop into cancer if not monitored or treated. 

Currently in the UK, everyone eligible between the ages of 25 – 65, are invited to attend their cervical screening appointment every three to five years (there are slight variations in different areas of the UK). The cervical screening test helps to prevent cervical cancer by looking for several high-risk strains of HPV on the cervix, the virus which causes nearly all cervical cancers. If HPV is present, the sample is then looked at under a microscope (called cytology) to see if there are any changes to the cells which could later develop into cancer, which are called Cervical Intraepithelial Neoplasia (CIN).  

If someone is found to have HPV and cell changes they will be referred to a colposcopy appointment, where a type of microscope called a colposcope is used, along with a speculum, to take a closer look at the cervix. This will help the doctor to grade the cell changes and decide the best plan of action. The cervical cell changes will then be either treated or monitored to prevent cancer from developing. 

This research found that with the improvements the WID-qCIN test could bring to cervical screening, it could reduce the number of women needing to be referred for a colposcopy appointment. This could prevent many women from the extra anxiety and disruption of further appointments, tests and waiting for results in the future. 

The combination of the WID-qCIN test and HPV type 16/18 test, was much better at predicting who would go on to develop cancer or precancerous changes in the future, despite if the cytology or colposcopy results were normal at the time the sample was collected. It predicted 69% of all cancers and precancerous cell changes up to six years after the sample was taken, compared to just 18% with current screening methods. In the future, the WID-qCIN test could help to better identify those patients whose HPV infection is most likely to develop on to high-grade pre-cancerous changes, and help guide decisions on whether people need treatment or monitoring. 

The WID-qCIN test works by looking at the DNA methylation of cervical cells and is therefore more objective than cytology. DNA methylation sits on top of DNA and tells cells which parts of the genetic code to read, like software in a computer if the DNA is the hardware. It can be affected by environmental and lifestyle factors, like genetics, diet, smoking etc., and some changes can increase the risk of certain diseases such as cancer. The researchers are using it as a tool to not only detect pre-cancerous lesions, but to potentially even predict the future risk of cancer.  

The WID-tests were borne out of the FORECEE programme which is developing one screening test to predict the future risk of four key cancers in women: breast, womb, cervical and ovarian, which The Eve Appeal has supported thanks to your generosity. 

Athena Lamnisos, Eve CEO commented:

Publication: “Cervical cancer screening using DNA methylation triage in a real-world population”, Lena Schreiberhuber, James E. Barrett, Jiangrong Wang, Elisa Redl, Chiara Herzog, Charlotte D. Vavourakis, Karin Sundström, Joakim Dillner, Martin Widschwendter, Nature Medicine, online 4 June 2024, doi: https://doi.org/10.1038/s41591-024-03014-6