The TERC test, a new molecular assay, examines abnormalities of the telomerase RNA component (TERC) gene based on knowledge about which molecular changes turn cervical dysplasia into malignancy. This knowledge comes from National Institutes of Health (NIH) research demonstrating that the TERC gene is amplified in the precursor cells of cervical cancer.1,2
Neal M. Lonky, MD, MPH
This is the evolution from interpreting anatomical microscopic features to molecular markers associated with cellular proliferation that move our paradigm from “snapshot” diagnosis to a “movie preview” of the prognostic significance of the lesions of the cervix. Like other molecular markers, it will help us assess risk more accurately, preventing unnecessary visits and treatment in the lower risk cohort (with the associated stress and complications), while moving those positive for the markers to appropriate care.
Dr. Lonky is clinical professor of obstetrics and gynecology at the University of California–Irvine and a member of the board of directors of Southern California Permanente Medical Group. Dr. Lonky is an OBG Management contributing editor.
When standard screening like the Pap smear and human papillomavirus (HPV) test do not provide clear results about a patient’s cervical cancer risk, the TERC test will enable detection of specific cancerous characteristics.
Following TERC and HPV testing, women at high risk can undergo additional cervical biopsy under colposcopy and benefit from more aggressive observation and treatment. Women found to be at low risk may not have to undergo extensive follow-up.
It is estimated that almost 12,000 new cases of HPV-associated cervical cancer are diagnosed in the United States each year.3 It is estimated that this test could help detect cervical cancer in more than 1.5 million women with ambiguous Pap test results.2
One of NIH’s goals is to evolve their scientific discoveries into clinically valuable technologies through collaboration with commercial organizations, which is how Quest Diagnostics acquired a nonexclusive patent license for the human TERC gene marker.2
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