Human Papillomavirus (HPV) and Molecular Testing for Cervical Cancer
Continuing Education Credits
Human papillomavirus (HPV) is a frequently occurring viral infection that is sexually transmitted. HPV infections often present with mild symptoms or are asymptomatic and do not always progress to a disease state. However, some HPV infections can cause cervical or other anogenital carcinomas. If HPV screening is done regularly, most cervical cancers can be prevented. In fact, cervical cancer is one of the most successfully treated cancers. Management of HPV has changed dramatically with the introduction of DNA methods for diagnosis of HPV infections, and vaccines for the prevention of HPV infections. This course is intended to increase your knowledge about HPV and to acquaint you with molecular methods that are currently available for detection of HPV DNA in cervical cells.
Objectives
- Describe human papillomavirus (HPV) structure, genome, and encoded proteins.
- Identify high-risk and low-risk HPV types and the relationship between HPV and cervical cancer.
- Identify the symptoms, causes, and risk factors associated with cervical cancer.
- Describe the carcinogenesis of cervical cancer including a description of tumor suppressor genes, oncogenes, and the virulence of HPV types 16 and 18.
- Compare and contrast the FDA-approved molecular assays for high risk HPV types.
- Compare and contrast vaccines to prevent HPV infections.
- Evaluate appropriate and inappropriate utilization of molecular testing for HPV DNA in cervical cancer screening.
- Discuss basic molecular diagnostic processes: denaturation, hybridization, and types of amplification methods.
- Discuss basic molecular diagnostic processes: denaturation, hybridization, and types of amplification methods.
- Discuss basic molecular diagnostic processes: denaturation, hybridization, and types of amplification methods.
Course Outline
- Human Papillomavirus (HPV)
- Introduction: HPV and Cervical Cancer
- Organizations and Agencies
- HPV as a Virus
- HPV Structure
- HPV Viral Types
- Low-Risk and High-Risk HPV Types
- HPV Genome and Proteins
- Which of the following HPV types are high-risk HPV types and most commonly isolated in cervical caners?
- Select the statement that correctly describes the HPV genome and its encoded proteins.
- HPV as a Sexually Transmitted Infection (STI)
- HPV as a Sexually Transmitted Infection (STI)
- Clinical Diseases Caused by HPV STI Types
- True or False: Most genital condylomas and cervical lesions caused by HPV resolve as a result of the immune response in the infected individual.
- Which HPV virus types do not cause cancer but can account for 90% of all genital warts?
- Cervical Cancer and HPV Types
- Overview of Cervical Cancer
- Symptoms, Causes, and Risk Factors for Cervical Cancer
- Staging of Cervical Cancer
- Cervical Cancer Treatment and Prognosis
- Cervical IntraepitheIial Neoplasia (CIN) and Immune Mediated Regression
- Life Cycle of Human Papillomavirus
- Review: Tumor Suppressor Genes, Proto-Oncogenes, and Oncogenes
- Carcinogenesis of Cervical Cancer
- True or False: HPV infection can linger for years in cervical cells and eventually convert normal cells into malignant cells.
- Which gene or genes in HPV control(s) the production of E6 and E7 in the normal viral life cycle?
- Papanicolaou (Pap) Test and Cervical Cytology Testing
- Overview of the Pap Smear
- Cervical Cancer Diagnostic Procedures
- What is a diagnostic procedure that examines an illuminated, magnified view of the cervix, vagina, and vulva, usually when an abnormality is found and requires closer scrutiny?
- HPV Molecular Diagnostics
- Molecular Detection of HPV
- Molecular Detection of HPV in Cervical Cytology Specimens
- Review: Nucleic Acids and Molecular Diagnostic Testing
- Molecular Testing Basics
- Hybridization
- Amplification
- Review the descriptions of molecular testing techniques and select the correct statements.
- Types of Molecular HPV Testing
- FDA-Approved HPV Tests
- High-Risk HPV Hybrid Capture (HC) 2 DNA Test
- Cervista HPV DNA
- Cervista HPV DNA, continued
- Comparison of Digene and Cervista HPV DNA Tests
- Cobas HPV Test
- Cobas HPV Test, continued
- Should the HPV Test Be Used as a First-Line Primary Cervical Cancer Screen?
- Should the HPV Test Be Used as a First-Line Primary Cervical Cancer Screen? (continued)
- Which statement is not true when describing the Digene Hybrid Capture 2 High-Risk HPV DNA test?
- True or False: The FDA granted the Cobas HPV test the first HPV FDA approval for expanded use, including use as either a co-test or a primary cervical cancer screening test.
- Updated Guidelines for Cervical Cancer Screening
- Updated Cervical Cancer Screening Guidelines for Pap and HPV Testing
- Prevention of HPV
- HPV Vaccines
- References
- References
Additional Information
Level of instruction: Intermediate
Intended Audience: Medical laboratory scientists, medical laboratory technicians, laboratory supervisors, and laboratory managers. This course is also appropriate for MLS and MLT students and pathology residents.
Intended Audience: Medical laboratory scientists, medical laboratory technicians, laboratory supervisors, and laboratory managers. This course is also appropriate for MLS and MLT students and pathology residents.
Author information: Mary Ellen Koenn, MS, MLS(ASCP), is an associate professor emeritus at West Virginia University School of Medicine, Medical Laboratory Science Program. She has been a medical technologist, educator, laboratory supervisor, and manager and holds several teaching positions. She is the author of numerous articles for laboratory publications and textbook chapters and is a frequent presenter at laboratory seminars and workshops. Ms. Koenn holds a Master of Science degree in Medical Technology.
Reviewer information: Joshua J. Cannon, MS, MLS(ASCP)CMSHCM received his Bachelor
of Science and Master of Science in Medical Laboratory Science from Thomas
Jefferson University in Philadelphia, PA. He holds Medical Laboratory Scientist
and Specialist in Hematology certifications through the ASCP Board of
Certification. He was a professor at Thomas Jefferson University for seven
years before transitioning into his current role as Education Developer at
MediaLab. His areas of expertise and professional passions include clinical
hematology and interprofessional education.
Course Description: This course discusses the various types of human papillomavirus and their association with cervical cancer. It also discusses molecular detection methods, beginning with a fundamental review of nucleic acid amplification and hybridization methods. Two FDA-approved methods for molecular HPV testing are briefly explained. The course also presents four case studies demonstrating the correct and incorrect utilization of HPV molecular methods.