Better HPV test preventing cervical cancer than Pap smear

  • Better HPV test preventing cervical cancer than Pap smear

Better HPV test preventing cervical cancer than Pap smear

During the first round of screening, a human papillomavirus (HPV) test detected more abnormal cells grade 3 or worse in the cervix than a Papanicolau (Pap) smear, resulting in a lower liklihood of abnormal cells grade 3 or worse at 48 months. Some are still skeptical of relying on HPV testing alone, and co-testing, or using both the HPV test and a Pap smear, is still the standard.

This is confirmation of the need for enhanced cervical cancer screening methods. However, repeated or persistent infections can cause cellular changes in the cervix, eventually developing into precancerous lesions which can become malignant. About 4,200 women will die of the disease.

The study bolsters previous research that showed that HPV testing was superior to Pap tests. The US Preventive Services Task Force now recommends a Pap smear every three years or co-testing every five years for women age 30 and up, but it is considering changing that recommendation to just one test or the other, and this study could speed things along, NPR reports. It was published this month in the Journal of the American Medical Association. Additionally, they could not be diagnosed with invasive cervical cancer or have received a total hysterectomy. "In most places that's not the case", Dr. Kathleen Schmeler, associate professor in gynecological oncology and reproductive medicine at the University of Texas MD Anderson Cancer Center, who was not involved in the study, told ABC news.

"That's a lot of women that are unnecessarily anxious", she says.

But Mark Spitzer, a gynecologist in New Hyde Park, New York, and past president of the American Society for Colposcopy and Cervical Pathology, disagreed. "If you tested everyone for HPV in their 20s, they are nearly all going to be positive, but there's going to be all of this intervention that's not needed", she said.

"Although cervical screening guidelines from a number of organizations have recommended primary HPV testing based on the natural history of cervical cancer, cross-sectional studies, studies where HPV-based screening was part of a screening group, or where studies ultimately evolved into primary HPV evaluations, none of these studies were designed specifically to examine HPV testing as the primary screening modality", Ogilvie reported. The women who tested negative with the HPV test returned four years later.

The study documented the results of a randomized clinical trial comparing Pap smears with the use of HPV tests. "If women have a negative HPV test, they are significantly less likely to have a precancerous lesion four years later, meaning we can extend screening time". Patients were followed for a 48-month period. The two groups were again tested with both the methods post of 4 years.

The Pap test identifies abnormalities in cervical cells, flagging health-care providers to take a closer look to see if they are precancerous, and then take appropriate action. That's because cases of worrisome cellular changes already had been detected and dealt with after the women were first screened, said lead author Gina Ogilvie, a physician and public health researcher at the University of British Columbia.

"It's really unbelievable, there's no other test that gives us this level of reassurance for that period of time for a cancer", Harper says. Altogether, 17% of the variation in genetic testing rates could be explained by surgeons' practice patterns, the study found. The final round of cotesting found additional abnormal cells in some women who originally tested negative in both groups.

"This supports the small, but significant benefit of co-testing". The study inferred that HPV testing could be comparatively much more accurate.

They also cautioned that more work needs to be done to assess the economic consequences of changing the screening model. But when infections last longer, they can cause not only cervical cancer but also cancer of the anus and back of the throat, as well as cancer of the penis.

That's why doctors strongly recommend that children and young adults be vaccinated against HPV; a vaccine was approved by the Food and Drug Administration in 2006. According to the article, the researchers surveyed 5080 women treated for early-stage breast cancer by 377 surgeons in Georgia and Los Angeles between 2013 and 2015.

The United States Preventive Services Task Force, an independent panel that reviews the evidence of effectiveness for preventive services, now recommends the "co-testing" for signs of cervical cancer that other groups advocate. Women with negative Pap smear results received a second Pap smear after 24 months. This new study could prove important in deciding on practice guidelines.