Australian Doctor Australian Doctor 29th September 2017 | Page 5

HPV screening vindicated ahead of switch

JOCELYN WRIGHT WITH just two months to go before HPV screening replaces Pap tests, the new method has been shown to offer 10 times better detection rates for cervical changes.
A study of almost 5000 women led by the Victorian Cytology Service( VCS), found that primary HPV screening had a 1 % detection rate for high-grade cervical precancerous lesions( CIN2 +) compared with just 0.1 % for liquid-based cytology.
Colposcopy referral rates were 3.8 % for HPV screening and 2.7 % for cytology in the trial that involved 1000 women who were age-eligible for HPV vaccine.
Co-author Associate Professor Marion Saville, executive director of the VCS, said the results provided real-world evidence of how well new primary screening pathways worked in practice.
“ It’ s definitely going to be more
effective than our current screening program … you’ re safer at five years if you have a negative HPV test than two years after a negative Pap smear,” she said.
‘ It’ s definitely going to be more effective than our current screening program.’
— Professor Marion Saville Executive director of VCS
Professor Saville said a smooth transition from Pap tests to primary HPV screening in December was expected as many GPs were already using liquid-based cytology
.
“ Feedback … is strongly indicating that GPs feel confident about what to do when the renewed program starts,” Professor
Saville said.
Gold Coast GP Dr Jane Smith, who has an interest in women’ s health, said it would be down to GPs to explain program changes such as extending the screening interval to five years.
“ There hasn’ t been a great public education campaign but I think women trust that whatever way their cervical cancer screening happens, it’ s a valid method and they trust in their GP’ s advice,” Dr Smith said.
“ It’ s not a hard message to sell because most women don’ t enjoy having a Pap smear every two years,” added Dr Smith, who is head of General Practice at Bond University.
When asked about a public education campaign for the impending changeover, a spokesperson from the Department of Health said there was a plan to implement and support the program. PLOS Medicine 2017; online

Turnbull sours over sugary drink tax

PAUL SMITH AND AAP A RENEWED push for a tax on sugary drinks turned sour within hours after Prime Minister Malcolm Turnbull told campaigners to take a walk last week.
The health lobby proposed a 20 % tax on sugar sweetened beverages, along with tougher restrictions on junk food adverts and a mandatory health star ratings system.
But even as sugar taxes are being introduced in other countries, Mr Turnbull claimed it was not the solution, suggesting encouraging people to“ get up and walk” was a better approach.
“ I think we have enough taxes and there are enough imposts on us all when we go to the supermarket and go shopping,” he said.
[ Food ] labelling is very important, as are health messages through the media... and exercise. Get up and walk,” he advised.
He was also particularly alarmed that orange juice could be unfairly hit under the plan.
“ Where do you draw the line? There is a lot of sugar in a bottle of orange juice,” he noted.“ Are you going to put a tax on that?”
The groups calling for the tax include the Obesity Policy Coalition, Cancer Council and the Heart Foundation.
Around two-thirds of Australian adults and 27 % of children are either overweight or obese, with an estimated annual cost to the health budget of about $ 8.6 billion.
Obesity Policy Coalition executive manager Jane Martin said the costs would escalate if the government did not act to address the problem.
Mexico introduced a tax on sugary non-alcoholic beverages three years ago.
A 2016 study published in the BMJ estimated that the tax reduced sugary drink consumption by about 6 % in the first year— the equivalent of 500 million litres of Coca-Cola. BMJ 2016; online.
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