New options to detect a virus that causes cancer
Catherine, a trained gynecologist, has always been passionate about making a difference in women’s health. She joined Roche to work on a screening tool for cervical cancer. When the early signs of cervical cancer are caught early, there is a much better chance of effectively treating or even preventing the development of the disease.
After getting my Ph.D. in molecular endocrinology at the University of California at San Francisco, I went to medical school at Stanford and also completed a residency programme there in obstetrics and gynecology. I became very committed to patient care, which postponed my plans to return to research. Sometimes, though, I wondered how much impact I was having on the 15-20 women I saw each day and how much more I would have in research.
An issue that troubled me was the screening procedure for cervical cancer. The standard of care for detecting cervical pre-cancer using cytology, known as the ‘Pap smear,’ had reduced the incidence of cervical cancer by an impressive 75%. The test, however, involved looking at tissue samples under a microscope, which means a chance of human error. There were also many borderline Pap smears that did not provide us physicians with a clear basis for making decisions. On the other hand, we began to think that human papilloma virus (HPV), the principal cause of cervical cancers, would be a better target for screening.
There are more than 100 known types of HPV and at least 14 of them are known to cause cervical cancer. However, two strains of HPV—16 and 18—cause 70% of cervical cancer cases worldwide and pose the highest risk for developing malignancy.
This growing understanding of the disease has led to the development of advanced diagnostic solutions such as molecular HPV testing and techniques to assess if biomarkers associated with the development of disease are present.
In 2009, I began working with Roche as a consultant on a clinical trial. I was asked to join the company six months later as the Clinical Leader for a test study. For me as a gynecologist, this was an exciting opportunity.
We took into consideration the fact that cytology and molecular testing methods work well together for cervical cancer screening. As a primary screen, HPV tests with their sensitivity ‘cast a wide net’ to detect the presence of the virus. Those women who test positive for the most dangerous HPV strains, subtypes 16 and 18, are at the highest risk and should undergo further checking for pre-cancerous cells. On the other hand, women who test positive for the 12 other high-risk genotypes can be screened with the more specific Pap smear to see if further interventions are warranted.
The widespread introduction of these advanced diagnostic solutions in screening programmes has the potential to help reduce the risk of cervical pre-cancer or cancer going undetected. It’s very rewarding for me to see the tremendous progress which is being made in cervical cancer detection. My dream was always to have a direct impact on women’s health.