Study Finds HPV Test Viable Alternative to Pap Smear

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

Approved by the FDA in 2014, the HPV test is a relatively new alternative to Pap smears. The HPV test identified significantly more precancerous lesions earlier, and four years after the women were initially screened, they received both an HPV test and a Pap test. 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.

The research came from doctors and scientists working on Canada's cervical screening programme, including researchers from the University of British Columbia, British Columbia Centre for Disease Control, Lower Mainland Laboratories, British Columbia Cancer and McGill University.

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. They noted that women who had a negative HPV test were more likely to be cancer free for the next four years compared to those who got a negative Pap test.

Women should discuss the risks and benefits of each test with their doctor, Wright said. Two years later, the ones that tested negative after the Pap smear had another test of the same type. Some of them used the regular Pap smear screening, while others used the HPV testing.

Kathleen Schmeler, a gynecological oncologist at MD Anderson Cancer Center who was not involved in the study, was enthused about the new results.

The team of researchers included 19,009 women over the age of 25 years and screened them using either Pap test alone or HPV testing alone. Also, there are various HPV DNA tests available globally, where majority are FDA approved for detecting high risk HPVs. Harper notes that using both Pap smears and HPV testing can mean up to 30 percent of women could have a false positive. In 2017, the researchers running the study reported that there were significantly more cases of precancerous lesions detected early in the trial among the women in the HPV-tested group, compared with the Pap cytology group.

"HPV may recur and first be detected decades later in the context of long-term monogamy or abstinence", wrote Massad, who helped advise the Food and Drug Administration on approving the first HPV cervical cancer screening test.

Several experts predicted the results would spur efforts to entirely replace the Pap test with the HPV test.

Most cases are preventable with screening the best way of catching it before it develops. "Even if we could magically vaccinate 100 percent today, it would take 30 years for them to reach the age of 40, and to see a meaningful decrease in cervical cancer", Spitzer added.

Although there could be increased costs associated with sending more patients for additional tests and monitoring after HPV detection, those may be offset by the fact that people may not need to have the initial screening as often, she said. The women who actually received Pap smear showed twice more chances of having abnormal cells. But there were still no final guidelines issued on this and that's why the new study might be important in helping with the decision.

Human papillomavirus (HPV) is a DNA virus from the papillomavirus family. They can't rely on HPV testing, Schmeler says, because nearly everyone in that age group will contract HPV, and in many cases it goes away on its own. However, it looks like neither test was completely certain, as abnormalities were found in women from both groups who tested negative previously. He cites the small group of women who had abnormal cells discovered through a Pap smear at the end of the study period.

Medical students learn how to insert a speculum, part of the process of performing a Pap smear.



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