New blood test from Aiims detects cervical cancer earlier, cheaper: Details

The ₹2,500 test detects HPV DNA in blood, offering early relapse warnings, simpler follow-ups, and a cost-effective alternative to scans and biopsies

A highly sensitive blood test developed by the All India Institute of Medical Sciences (Aiims), Delhi, promises to simplify the monitoring of cervical cancer treatment. The non-invasive test can help determine whether a tumour is responding to therapy or if the cancer has relapsed.

 

This first-of-its-kind test, based on droplet digital polymerase chain reaction (ddPCR) technology, detects fragments of human papillomavirus (HPV) DNA circulating in the bloodstream. These fragments are strong indicators of tumour size and response to treatment.

 

The study, titled “Prognostic value of circulating HPV cell-free DNA in cervical cancer using liquid biopsy”, was led by a team of oncologists and molecular scientists, including Dr Mayank Singh, Associate Professor of Medical Oncology at Aiims. It has been published in the Nature group journal Scientific Reports. The findings have the potential to transform how cervical cancer is monitored and play a significant role in reducing India’s cervical cancer burden.

 

 

According to Dr Singh, while most cancers have a predictive blood marker—for instance, CA-125 for ovarian cancer—cervical cancer has long lacked a simple predictive test. “This simple blood test can become a game-changer in tackling one of the most common cancers among women in India,” he said.

 

He explained, “If you look at cervical cancer cases in India, most patients present at a late stage. They come to the cancer OPD when the disease has already progressed, often reaching cervical intraepithelial neoplasia (CIN), where abnormal cells have formed on the cervix surface. In such cases, liquid biopsies—which analyse circulating tumour cells or cell-free tumour DNA (ctDNA)—are emerging as promising tools. However, detecting markers for cervical cancer requires highly sensitive technology to quantify circulating HPV DNA.” He added, “Despite being vaccine-preventable, cervical cancer still claims thousands of lives every year, primarily due to late diagnosis and poor access to regular screening, particularly in rural and underserved regions.”

How the Aiims blood test works and what it reveals

The new test is based on the concept of a liquid biopsy, where circulating tumour DNA (ctDNA) is extracted from a blood sample. In this case, researchers targeted HPV DNA fragments, known as circulating cell-free HPV DNA (ccfHPV DNA), as biomarkers.

 

“We used droplet digital PCR to measure HPV DNA levels in the blood of 60 cervical cancer patients at baseline and then again after three months of therapy,” said Dr Singh. “We found that the levels dropped significantly in patients whose tumours responded to treatment, offering a simple, non-invasive way to monitor progress.”

 

The test demonstrated that high levels of HPV DNA in the blood correlate strongly with tumour size and staging. Once treatment begins, a drop in these levels indicates tumour regression. Conversely, a spike during follow-up may signal relapse—often before it is visible on a CT scan.

When doctors should use the test and what it means for patients

The test should be used before treatment, after therapy, and during regular follow-ups to monitor tumour behaviour and catch recurrence early. It has the potential to reduce reliance on repeated biopsies and expensive scans, especially for patients from remote regions.

 

“You just need a simple blood draw. No hospitalisation, no scans. Within two days, doctors can determine whether the tumour is shrinking or recurring,” said Dr Singh.

 

Importantly, the test can also pick up relapse signals before clinical symptoms appear, allowing for timely intervention.

Tracking cervical cancer affordably: Why this matters

Patients often need multiple tests during and after treatment to monitor cancer progression or recurrence, which can be costly and difficult to access. The new blood test by Aiims provides a more affordable and accessible alternative.

 

“Blood biomarkers usually show up before tumours become visible on scans. This may help detect relapses sooner as well,” said Dr Singh. The cost of the test is currently around ₹2,500.

What cervical cancer is and how it is diagnosed

Cervical cancer refers to the abnormal growth of malignant cells on the cervix—the lower part of the uterus. According to the Cleveland Clinic, it often develops slowly and can remain asymptomatic for years, making early detection through screening essential.

 

It is the third most commonly diagnosed cancer among Indian women, after breast and endometrial cancer. According to the World Health Organization (WHO), over 127,000 cases were diagnosed in India in 2022, with approximately 80,000 deaths. More than 95 per cent of these were linked to persistent infection with high-risk HPV strains.

 

Screening methods include the Pap smear, where cervical cells are examined under a microscope; and visual inspection with acetic acid (VIA), where a vinegar solution helps detect abnormal cells. A biopsy is required for a confirmed diagnosis and staging.

Causes, symptoms and treatment options

Cervical cancer is caused primarily by HPV, a sexually transmitted infection. According to the Cleveland Clinic, “Most people will get HPV at some point in their lives and not realise it because their bodies fight off the infection. But if your body doesn’t fight off the infection, it can cause the cells of your cervix to change to cancerous cells.”

 

The disease is not hereditary. Risk factors include early sexual activity, multiple partners, and poor hygiene.

 

Symptoms often go unnoticed in the early stages but may include abnormal vaginal bleeding (especially post-intercourse or menopause), persistent discharge, pain during intercourse, and lower back pain. In advanced stages, patients may experience bowel or bladder issues, radiating pelvic pain, and leakage of urine or stool through the vagina.

 

Treatment options include surgery, chemotherapy, and radiation therapy.

HPV vaccination: A key tool in cervical cancer prevention

Dr Singh noted that vaccination is one of the strongest tools to prevent cervical cancer. “Vaccination is a strong defence against cervical cancer, and regular screenings become crucial after remission to detect relapse,” he said.

 

The Ministry of Health and Family Welfare (MoHFW) is currently evaluating the introduction of HPV vaccination for girls aged 9–14 under the Universal Immunisation Programme (UIP). Pilot programmes have been launched in states such as Delhi, Punjab, Sikkim, Karnataka, and Tamil Nadu.

 

Doctors recommend the vaccine for both girls and boys aged 9 to 45. Those aged 9–14 require two doses, while those aged 15–45 need three.

 

In June 2022, the National Technical Advisory Group for Immunisation (NTAGI) recommended adding HPV vaccines to the government’s UIP.

HPV vaccines currently available in India 

Cervarix (GSK): Two doses for females aged 10–45; ₹2,200–₹2,600 per dose

 

Gardasil 4 (MSD): Two or three doses for females aged 9–45; ₹3,500–₹4,000 per dose

 

Gardasil 9: Gender-neutral; two or three doses for girls 9–45 and boys 9–15; ₹9,000–₹10,000 per dose

 

Cervavac (SII): Two doses for girls aged 9–14; three doses for 15–26; ₹2,000 per dose

 

Doctors emphasise that regular Pap smears and practising safe sex remain essential steps in reducing cervical cancer risk.

 

A step forward in India’s fight against late-stage cancer

In a country where most cervical cancer patients are diagnosed too late for curative treatment, a non-invasive, affordable, and timely blood test could be a critical tool in bridging the gap between diagnosis and survival. As India builds out its screening and vaccination infrastructure, tools like this may help redefine cancer care — especially for underserved women across rural and low-resource settings.