A special test can show whether there has been a change in women’s DNA, which deactivates certain genes, making it possible to tell which women with the hrHPV virus have an increased risk of developing cervical cancer. This is the result of a study carried out by gynaecology registrar Aniek Boers from the UMCG. She was awarded a PhD by the University of Groningen on 20 October.
Worldwide, cervical cancer is one of the most common forms of cancer affecting women. It is caused by the high-risk human papillomavirus (hrHPV). Early-stage cervical cancer is easy to treat, which is why screening is offered to detect the changes that precede full-blown cervical cancer. In the Netherlands, all women between 30 and 60 years of age are offered a 5-yearly smear test as part of a national screening programme.
The test is set to change in 2016. Analysts will no longer study the shape of the cells (as they do now), but will instead look for hrHPV in the cells. A lot of women contract an HPV infection without developing any symptoms; this is because the body recovers of its own accord. However, if the body fails to rid itself of HPV, cervical cancer may develop.
Aniek Boers chose to study this particular subject to find out why so many women with the HPV virus do not develop cervical cancer. She hopes that a second, more specific test will stop women being referred to a gynaecologist unnecessarily, which is why she studied the DNA.
DNA methylation (a change in the DNA that suppresses the expression of certain genes) sometimes occurs in the early stages of cervical cancer. This can cause the ‘tumour suppressor genes’, which take care of normal organization in the cell, to be deactivated. Cancer cells take advantage of the situation by multiplying, sometimes forming a tumour.
Boers’ study showed evidence of new genes. These genes are deactivated during the early stages of cervical cancer but function normally in healthy patients. According to Boers, the DNA methylation test makes it possible to see which women with the hrHPV virus are at a higher risk of developing cervical cancer.
Boers can see two major advantages to the test. First, the test means that fewer women are referred to the gynaecologist unnecessarily, preventing worry and saving costs. Secondly, women can do the test at home using a special brush to take a sample for a smear test. This means that women who are too embarrassed to take part in the screening programme will now be able to do the test themselves.
Dr Aniek Boers (Emmen, 1983) studied medicine at the University of Groningen. She conducted her research in the Department of Obstetrics & Gynaecology, Gynaecological Oncology and Pathology of the UMCG. Her thesis is entitled ‘Innovative molecular markers for diagnosis and prognosis in cervical neoplasia’. Boers will continue to work as a gynaecology registrar in the UMCG
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