New test for cervical cancer on trial

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The Independent Online
SCIENTISTS HAVE developed a new smear test which, it is claimed, could reduce the error rate and avoid the blunders and scandals which have dogged the cervical screening service.

The test, pioneered by scientists at Cambridge, is in the early stages of trials, but the Cancer Research Campaign (CRC) claims it could save hundreds of lives each year and reduce the cost of the screening service.

At a press conference yesterday Frank Dobson, the Health Secretary, said that if full clinical trials supported the early results it would be introduced regardless of cost.

At present using the conventional Pap test, screeners have to look at around 300,000 cells per smear, which makes it easy to miss abnormalities.

The new test works by using antibodies which home in on abnormal cells in a conventional smear test. A coloured dye is used to highlight the antibodies so that the abnormal cells can be identified more easily.

The antibodies home in on protein molecules call Cdc6 and Mcm5 which are only present on cells which have the potential to replicate. "Healthy" cells should not be dividing.

So far researchers have done a trial on 58 cervical smears and compared the findings of the new test with the Pap test and/or a cervical biopsy.

In this small sample the new test found abnormalities in three smears which had been diagnosed as normal by the Pap test. The three problem cases were then re-examined and shown to have low-grade abnormalities on the smear. Biopsies revealed high-grade abnormalities in all three cases.

The scientists say that in future the first level of screening could be carried out by computers, which would reduce the level of error and also free up screeners to examine more problematic smears. It is hoped that the clinical trials will be completed within three years.

Gordon McVie, director general of the CRC, described it as "one of the most exciting results" saying: "If large-scale trials prove successful I believe it could be an ideal solution to the mistaken cervical smear diagnoses which we have sadly heard so much about."

Last year a Department of Health report concluded that more than one in three laboratories where cervical smear tests are examined failed to meet national standards.

The screening service also faced criticism over the weekend when a report from the Public Accounts Committee said that there were still "significant failings" at every level.

Mr Dobson said that the Government was determined to raise the reliability of cervical and breast cancer screening. "No test can be perfect but the standard in many places was simply not good enough," he said. "The system was failing and the system is being changed. But this new development, if it proves effective and reliable, could make the job a lot easier by easing the task of cytology screeners and giving a massive boost to the accuracy of the test."

He added that "no financial considerations" would delay the implementation of the test if it proved a success in clinical trials.

A spokeswoman for the NHS cervical screening programme said she welcomed any research which offered improvement. "However any new test needs to be carefully assessed to ensure it is both clinically effective and cost- effective," she said. "The CRC test is clearly in the very early stages of development and has so far undergone limited testing."

Cancer of the cervix is the fifth most common cancer among women. The NHS screening programme was set up in 1988, and women aged between 20 and 64 are called for a cervical smear every three to five years. Since 1988, deaths have fallen by a third.