is this why we are in gbi

DECA and others I've bought into this in the past few weeks after my mate at UBS gave me the heads up on this as one to take a postion in. I have been doing a bit of background reading and came across this piece (see below). My take on it is that genotyping is the way of the future re HPV testing as doctors need to be able to distinuish between persistent infection with high risk HPV and persistent infection with the same genotype of high risk HPV...the latter causing cervical cancer and the former just a fairly harmless transient viral infection?

Interested in your thoughts guys?

cheers



Study: HPV test more accurate than Pap smear

The Pap smear, which has led to a 70% drop in the U.S. cervical cancer death rate over the past six decades, is moving closer toward obsolescence as a primary screening test for the disease in women 30 and older, conclude the authors of a Canadian study out Thursday.
The researchers enrolled more than 10,000 women ages 30-69 in their study comparing the Pap smear, named for developer George Papanicolaou, with a test for human papillomavirus, or HPV, certain types of which cause virtually all cervical cancer cases. All of the women were screened with both tests, but they were randomly assigned to get either a Pap smear or an HPV test first.
As smaller, less-rigorous studies have found, the HPV test picked up far more cervical pre-cancers than the Pap smear did, the researchers write in The New England Journal of Medicine. "The paper clearly comes across strongly in favor of HPV testing as a primary screening test," says senior author Eduardo Franco, a cancer researcher at Montreal's McGill University. Only women who test positive for a cancer-causing HPV type would then have a Pap smear, Franco says.
One concern about the HPV test has been a higher rate of false positives due to its superior sensitivity, but Franco's study found only a small difference between the two screening tools. He calls the increased rate a false positives, which could lead to unnecessary additional testing, a fair tradeoff for detecting far more cervical pre-cancers — 94% vs. 55% — and, probably, allowing women to screen less frequently. The most recent American Cancer Society guidelines, issued in 2002, recommend that women with negative HPV tests and Pap smears wait three years before being screened again.
Only one Food and Drug Administration-approved HPV test, made by Digene of Gaithersburg, Md., a Qiagen company, is sold in the USA. It is approved only for use in women over 29 as a follow-up to inconclusive Pap smear results or as a "co-test" done at the same time as a Pap smear. It is not approved as a stand-alone primary screening test. About one out of four women who are eligible for the Digene HPV test currently are getting tested, Qiagen spokesman Jeff Schmalz says.
HPV infection in younger women usually disappears on its own, so testing those under 30 would lead to many false positives, notes Diane Harper, a Dartmouth associate professor of community and family medicine and obstetrics and gynecology who has long been involved in HPV-related research. Only when infection with cancer-causing HPV types persist are women at risk for developing cervical cancer. Some other types of HPV, the most common sexually transmitted virus, cause genital warts.
Debbie Saslow, director of breast and gynecologic cancer at the American Cancer Society, says it is "a matter of time" before her organization and other U.S. groups recommend the HPV test as a stand-alone screening tool in women 30 and older and those who have been immunized with an HPV vaccine. Gardasil, the only HPV vaccine on the market, protects against the two types that account for about 70% of cervical cancer cases, which means women still need to be screened for cervical cancer.
Digene's test screens for the top 13 cancer-causing HPV types, although it can't specify which one is present. The drawback to using it as a stand-alone primary screening test, Harper says, is that doctors can't tell whether a woman who tests positive repeatedly has a persistent infection with one HPV type or a series of transient infections with different types.
The cancer society probably won't recommend HPV testing as a stand-alone screening tool until one that can identify the specific type becomes available, Saslow says. "It is possible that other technology will be introduced in the meantime."