HPV test better at detecting cancer than a Pap smear

Pearl Mccarthy
July 7, 2018

Those who have low-grade changes and HPV will then be referred for further tests (a colposcopy). They detect only around 55 percent of true cases, according to a study by the Canadian Cervical Cancer Screening Trial Study Group, and requires a special process using a liquid medium that takes several days. At the end of the four years the women were tested using both tests. However, human papillomavirus (HPV)-based testing may be a more accurate way of testing for cervical cancer, new study results suggest. However, major organizations, such as the American Society of Clinical Oncology, have called for clinical trials involving HPV testing alone for more than 1 round of screening to further inform the implementation of the screening. Dr Kathleen Schmeler, a gynaecologic oncologist at The University of Texas MD Anderson Cancer Center said, "The bottom line is that it could really potentially simplify how we screen women and have it been more effective and not quite as complicated and burdensome - and opens the door for doing just HPV testing which is actually what's now recommended by the World Health Organisation for countries that don't have Pap testing capabilities". The women in the second group received another Pap after 2 years.

None of the methods yielded fully accurate results. Overall, approximately 35% of patients had an elevated risk of carrying a genetic mutation, but just 27% of women in the study received genetic testing, the article reported.

Pap smear tests are also referred as Pap test or smear test or cervical smear test, in which Pap smear is prepared by collecting cells from outer cervix opening of the uterus and endocervix.

Approved by the FDA in 2014, the HPV test is a relatively new alternative to Pap smears.

The study finds two key advantages to the HPV test, says Gina Ogilvie, MD, a professor of public health at the University of British Columbia, Vancouver. The researchers observed that women who were HPV-negative at baseline were significantly less likely to have CIN2+ or CIN3+ at 48 months compared with those who had negative Pap smear results at baseline. On the other hand, two women in 1,000 that came negative with HPV testing showed precancerous lesions. 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.

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".

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However, 48 months after the start of the study, there were fewer cases of CIN3+ among women who had HPV tests than among smear tests, presumably because they had been found and treated in the first round of screening. 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. About 4,200 women will die of the disease.

Spitzer said those three cases support the "small but significant benefit of co-testing".

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".

One caution about the study findings, says Dr. Carol Mangione, a USPSTF task force member and UCLA professor of medicine, is that screening - either kind - is what saves lives. In turn, gynecologists might change which tests they recommend for their patients.

"At the moment, at most, we may be vaccinating at most 30 to 40 percent of girls".

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