Enhancing cervical cancer detection using nucleic acid hybridization and acetic acid tests.

Acetowhitening of abnormal cervical epithelium has been suggested as an indicator of increased cervical cancer risk. The presence of human papillomavirus (HPV) types 16, 18, 31, 33 and 35 may also indicate increased cervical cancer risk. Hence, tests that detect these two abnormal conditions may augment that Papanicolaou smear (Pap test) as predictors of cervical cancer risk. The cohort consisted of 145 women aged 14 to 47 (mean 21 years) attending health clinics. Thirty women (20.6 percent) showed acetowhitening of the cervical epithelium following exposure to vinegar of 4-percent acetic acid content. Fourteen (9.6 percent) had a positive Pap test and 13 (9 percent) carried a cervical HPV infection as determined by the commercially available ViraPap and ViraType nucleic acid tests. Statistical analysis of the data showed a positive correlation between Pap, ViraPap and acetic acid tests results. The acetic acid test and the nucleic acid tests were the sole positive tests for 21 (14.5 percent) and nine (6.2 percent) women, respectively. Four women with negative Pap results were infected with HPV types previously shown to have an association with cervical intraepithelial neoplasias, carcinoma in situ and cervical cancer. The authors have concluded that the acetic acid and nucleic acid tests detect women at risk for cervical cancer who would not have been detected by the Pap test alone.