Challenges and costs of detection
Tests that can detect the unique DNA signatures of various HPV types are not widely available and are expensive. To date, successful, established disease prevention strategies have been limited to screening for, and treating, the most common malignancy induced by HPV. Cervical cancer is the second most common cause of cancer death in women worldwide and studies have shown that HPV infection is the major risk factor.
Though Canada has been a pioneer country in reducing the incidence of cervical cancer using Pap test screening (the Pap test looks for changes in the cervix that might lead to cancer), the disease is still a major problem because detection is both challenging and costly:
- Screening is more accurate with highgrade lesions — early cervical cancer is often present without symptoms so many cases escape detection.
- Resources to detect cervical cancer are expensive for the health care system:
- In Canada four million Pap tests are done each year at an estimated cost of $200,000,000.
- An abnormal Pap test generally means additional testing is required — each year an average of 325,000 Pap tests are abnormal, leading to colposcopy and/or biopsy at an estimated cost of close to $50,000,000.
The burden associated with not being able to detect cervical cancer is also costly:
- Many women don’t get tested - up to 50% of Canadian women with cervical cancer did not get an annual Pap test.
- Canadian studies show that about 60% of cervical cancers occur in women who have not been screened in the previous three years.
- The yearly overall cost of invasive disease and death in Canada from cervical cancer has been estimated at up to $270,000,000.
- It is estimated that every year cervical cancer causes an estimated 11,000 person-years of life lost.
