A new test can help to improve the clinical management of women who screen positive for human papillomavirus (HPV) infection in routine cervical cancer screening, an NCI-led study has shown. The test, called p16/Ki-67 dual stain, more accurately predicted whether an HPV-positive woman would go on to develop cervical precancer within 5 yearsExit Disclaimer, compared to a Pap test—the current standard for managing HPV-positive women. As HPV testing becomes more central to cervical cancer screening, “the challenge is how to best manage, or triage, HPV-positive women,” said senior investigator Nicolas Wentzensen, M.D., Ph.D., of NCI’s Division of Cancer Epidemiology and Genetics (DCEG). Dual stain testing measures the presence of two specific proteins, p16 and Ki-67, in Pap test samples. Previous studies have suggested that the combination of these two markers is better at identifying HPV-positive women who have precancers than Pap testing. The study’s lead investigator, Megan Clarke, Ph.D., M.H.S., also of DCEG, said that it addresses a critical question: “how often and at what time interval should HPV-positive women who test negative with dual stain come back for repeat screening?” In the prospective study, HPV-positive women who had a negative result on the dual-stain test had a low risk of developing cervical precancer over the ensuing 5 years, the researchers reported October 11 in JAMA Oncology. These women, they concluded, can safely wait 3 years before undergoing their next round of screening. “This is a very important study,” said Mark Stoler, M.D., associate director of Surgical Pathology and Cytopathology at the University of Virginia School of Medicine. It’s the first study performed in the United States, Dr. Stoler continued, “that really provides the assurance that [dual stain] is a better triage test” than the Pap test.