HPV test better at detecting cancer than a Pap smear

Henrietta Brewer
July 7, 2018

"When we think about cervical cancer screening, we want to think about it in the framework of how do we get this test in the hands of all women?" Infection with HPV types targeted by the vaccine has declined by almost two-thirds among teenage girls since HPV vaccination was recommended in the United States, according to a study that also found that there was a decrease in HPV infections among women 20 to 24. In both the groups, the final co-testing discovered more abnormal cells within some of the women who initially tested negative. For women under 25, the Task Force suggests use of Pap test alone because many of them are infected with HPV.

"Most cases of cervical cancer happen in women who have not been regularly screened, or who have been screened, but don't have access to appropriate treatment", she says.

There's another way to screen for cervical cancer risk, by directly testing for the human papillomavirus, or HPV, which causes 99 percent of cervical cancer.

Dr. Ogilvie added that, "So this study is the next step, showing that by using only HPV testing in a screening scenario, four years later, women who received HPV testing were less likely to develop precancerous lesions". They recommend that women between 21 and 65 should have a Pap smear every three years, but that women aged 30 to 65 may choose to have both the Pap smear and HPV testing together every five years.

Most cervical cancers are caused by a particular strains of the Human papillomavirus, or HPV.

A new study conducted by a team of researchers has revealed a yet simpler method to examine any condition of cervical cancer.

The researchers say the best way to prevent HPV is to receive the vaccine.

"These results have demonstrated that primary HPV testing detects cervical neoplasia earlier and more accurately than cytology", they wrote.

Many women who have HPV (usually acquired via sexual contact) eliminate it from their bodies within a year or two.

The study included patients from 2008 to 2012, and nearly half of them were tested using the HPV test. About 4,200 women will die of the disease.

Lead researcher Dr. Gina Ogilvie, a professor in the School of Population and Public Health at the University of British Columbia, in Vancouver explained that cervical cancer screening should be performed for all women who belong to the reproductive or childbearing age.

A new study published in the Journal of the American Medical Association could change that recommendation. Of the women who tested negative on the HPV test only 22 women showed abnormal cells (grade 3 or worse), while from the Pap smear group, 52 women ended up with abnormal cells. Both groups were tested again using both methods after four years.

In the United States, the conventional Pap smear has been largely replaced by a liquid-based Pap cytology test.

This trial showed that screening with HPV testing leads to earlier diagnosis of cervical pre-cancer and picks up cases that Pap testing missed, he said.

Of note, the Canadian Task Force on Preventative Health Care differs from the US task force - it recommends Pap smear screening every three years between ages 30 and 69, citing weak evidence for screening women ages 25 to 29. HPV testing was carried out by checking DNA samples.

"At the moment, at most, we may be vaccinating at most 30 to 40 percent of girls". These conditions can be treated before they progress to cervical cancer. "This has been building for decades", he said, adding that the Pap smear is "crude and inaccurate" while the HPV test is much more precise, operates on the molecular level and can provide information on the specific type of HPV causing the problem. Luckily, this study indicates that the HPV test is accurate enough that there are few false positives, in which a test identifies a disease that isn't actually there.

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