March 26, 2019

HPV test should replace Pap test for cervical cancer screening, study suggests

07 July 2018, 10:01 | Randall Craig

Study: HPV Test Beats Pap

For Women Over 30, There May Be A Better Choice Than The Pap Smear

For this, the doctors usually scrap the cells of the posterior part of a woman's cervix that are then visually scrutinized for any abnormality condition.

"This information will help inform future cervical cancer screening guidelines and continue to decrease deaths from this preventable disease", added Schmeler, who was not involved in the study.

"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. 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.

So the HPV test comes back positive for many younger women who are newly infected but who will probably clear it without it causing the damage that leads to cancer.

Researchers conducted cervical cancer screenings of 19,009 women in the Human Papillomavirus For Cervical Cancer (HPV FOCAL) trial from January 2008 to May 2013, and compared liquid-based cytology (LBC) results with HPV screening results of participants.

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. 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".

But in recent years, most medical groups have been recommending women get both tests, and some experts are pointing out that such so-called "co-testing" may be better than the HPV test alone at detecting precancerous changes; the study did find that in a small number of cases, Pap cytology identified precancerous lesions that HPV testing did not. At the end of four years, both groups received both tests.

Specifically, the task force is recommending either screening every three years with a Pap test alone or every five years with an HPV test alone for women aged 29 to 65.

None of the methods yielded fully accurate results.

Schmeler says that in the USA, it has been hard to justify replacing the Pap smear with the HPV test because there has not been a head-to-head comparison until now.

Researchers, led by the University of British Columbia, found that significantly more women showed signs of abnormal cells in the first round of HPV testing compared to the conventional smear tests, despite similar questionnaire responses.

'This study echoes other research which shows that testing for HPV first makes cervical screening more effective'. But one issue is that it was centered around one flawless system in British Columbia, where they had one place to send all of the Pap smears and HPV testing. This type of cancer is mostly caused by the human papillomavirus (HPV), in as much as 99% of all cases. The HPV test found nearly 60 percent more abnormal cells that could potentially become cancerous during the initial screening than the Pap test, bolstering previous research that showed that HPV testing was superior. However, if the virus persists until their 30s, that's when it becomes a problem.

The authors stated that one of the concerns related to primary HPV screening is lower CIN2+ specificity, "leading to higher screen positive rates and the resulting need for more colposcopies and biopsies".

"This is one study", he said.

"At the moment, at most, we may be vaccinating at most 30 to 40 percent of girls". However, the U.S. Preventive Services Task Force, which creates guidelines for the diseases people should be screened for and when, still recommends Pap smears every three years for most women with uteruses ages 30 to 65, NPR reports. This is why most women still choose both of them.

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