Jessica Nott
Screening for High Risk HPV
Summary of the EBP Study
The topic that I found interesting for current evidenced based practice research regards to
screening women for cervical cancer with high risk HPV testing. This study discussed new
potential techniques for early detections and treatment of precancerous cells that are linked to
high risk strains of human papillomavirus (hrHPV). This article also discussed the potential
harmful effects of unnecessary screening for cervical cancer using hrHPV as the screening
method (Melnikow et al., 2018). The population selection was a collection of screenings and
randomized trials in women ages 21 and older and cohort studies that compared screening
accuracy for precancerous lesions and patient satisfaction.
The fact that cervical cancer screenings is rather opportunistic to receive and is directly
caused by HPV with the high prevalence of HPV in our society makes this article very
interesting and applicable to the patient population in the United States. It is known that cervical
cancer develops over a period of years and can be prevented with early detection and treatment
of precancerous lesions that are primarily linked the hrHPV causing invasive cervical cancer
(ICC) (Melnikow et al., 2018). The study found that the evidence was not specifically clear if the
two different types of testing via: liquid based cytology testing for cervical intraepithelial
neoplasia (CIN3+) verses conventional cytology as primary pap smear hrHPV screening;
resulted in a significant difference for detecting high risk hrHPV cells due to a multitude of
uncontrolled variables (Melnikow et al., 2018). One study grouped that was tested was found
that the primary hrHPV testing has a two to three-fold increase in detection by using this
detection method (Melnikow et al., 2018). Also, the potential harm to patients resulted in the
psychological effect of receiving a false positive result and subsequent fear of sexual interactions
due to perceived risk of contracting HPV or undue further testing and colposcopies performed
(Melnikow et al., 2018).
Primary Recommendations
The primary recommendations within this report stated that further testing was required
in the U.S. to examine longer screenings and longer outcomes to effectively evaluate a larger
population of women who may have limited access. Melnikow (2018) also emphasized that “the
higher the sensitivity of hrHPV testing in a single round may have potential to improves
outcomes in the high-risk populations” (p. 7). The positive finding noted was that the study
showed consistent increased detection of hrHPV in both cytology testing types. The study also
recommended that further studies focus more on under screened women and define better
strategies of implementing guidelines to these underserved populations (Melnikow et al., 2018).
Relation to the Christian Perspective
APN’s are designed to be leaders in the nursing profession I am reminded of the bible
verse “So he shepherded them according to the integrity of his heart, and guided them by the
skillfulness of his hands” (Psalm 78:72, New King James Version). This verse exemplifies the
appropriate mindset for attaining professional expertise. Nursing research improves a nurse’s
ability to critically think, analyze current practice, and ultimately provide quality holistic patient
centered care.
References
Melnikow, J., Henderson, J.T., Burda, B., Senger, C.A., Durbine, S., & Soulsby, M.A. (2018).
Screening for Cervical Cancer with High-Risk Human Papilomavirus Testing: A Systematic
Evidence Review for the U.S. Preventative Services Task Force. Agency for Healthcare
Research and Quality (US), Evidence Synthsis, No.158. Retrieved from
https://www.ncbi.nlm.nih.gov/books/NBK526306
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