Better HPV test preventing cervical cancer than Pap smear

Better HPV test preventing cervical cancer than Pap smear

The study, published in the Journal of the American Medical Association, adds to a growing body of evidence that HPV tests may be superior to Pap smears.

Women can get a clear result from a simple HPV test and those who receive a negative result will be able to trust those results for several years, she says.

Suboptimal specificity of the HPV test is still a limiting factor for widespread adoption of the test as a cancer screening tool, write the authors of the editorial, "especially among populations of young women who often carry HPV infections that regress without oncogenic outcome". The conventional test has been largely replaced by a liquid-based Pap cytology test. Almost all cervical cancer cases are linked to HPV infection, and HPV testing detected pre-cancers earlier and more accurately than the Pap test among the 19,000 women in the Canadian study.

Most medical groups have recommended that women in the United States get both the HPV test and the Pap smear, a practice called "co-testing", and many medical doctors are urging this practice continue, like Dr. Dena Grayson, who brought it up on Twitter.

After follow up, researchers determined HPV testing detected significantly more CIN3+ cases in the first round of screening than did the Pap test (P .001). But last fall, it issued a draft recommendation proposing that women undergo either HPV testing every five years or Pap smears every three years, but a final recommendation has not been released. Some women might not even realize that they are being tested for HPV. He said that although the study confirmed previous research showing that the HPV test is more sensitive than the Pap test, it didn't answer a critical question: Is the HPV test alone better than the HPV test and the Pap smear together, as is current practice? After four years, all the women also got tested with both types of test. Additionally, they could not be diagnosed with invasive cervical cancer or have received a total hysterectomy.

Most cervical cancers are caused by a particular strains of the Human papillomavirus, or HPV. The Canadian task force does note that HPV testing may be recommended once more research is available. Gynecologic oncologist Dr. Kathleen Schmeler at the University of Texas MD Anderson Cancer Center, said in a statement, "In our world, this study is going to be a pretty big deal, in a good way".

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Pap smears rely on the human eye to get results, says Dr. Diane Harper, a professor of medicine who researches HPV at the University of MI, "and it's far preferable to detect problems on a molecular level". However, it looks like neither test was completely certain, as abnormalities were found in women from both groups who tested negative previously.

The women who took part in the study were aged between 25 and 65, had not had a smear test in the past 12 months, were not pregnant, and had no history of cervical cancer or pre-cancerous changes in the past 5 years. "The ASCCP [American Society for Colposcopy and Cervical Pathology] pointed out that just doing the HPV testing would miss some people, and so they advocated for co-testing".

It's possible these results were skewed because women received both treatment options at the end of the study.

"This supports the small, but significant benefit of co-testing".

The coverage in the Mail Online was accurate but failed to explain that one possible risk of changing to the new system would be an increase in "false positive" results, where women with HPV but no cancerous changes are referred for further investigations.

That kind of early detection is the hallmark of cervical cancer prevention, because health-care providers can take action to treat precancerous cells before they become cancer. About 4,200 women will die of the disease.

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