Tests that look for the human papillomavirus, or HPV, are more accurate than traditional Pap tests at detecting the precancerous lesions that lead to cervical cancer, according to a Canadian study of more than 19,000 women.
Lead researcher Dr. Gina Ogilvie, a professor in the School of Population and Public Health at the University of British Columbia, in Vancouver explained that cervical cancer screening should be performed for all women who belong to the reproductive or childbearing age. For women under 25, the Task Force suggests use of Pap test alone because many of them are infected with HPV. 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.
Women who had a negative HPV test at the start of the study were much less likely to develop CIN3+ within 48 months than women who had a negative smear test at the start of the study.
The HPV infection is the most common sexually transmitted infection and is usually eliminated by the immune system within a year or two. 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.
It's possible these results were skewed because women received both treatment options at the end of the study. Where it is hard to apply HPV tests over pap smear for United States as there hasn't been head to head comparison until now.
Schmeler says that in the US, 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.
'Research shows HPV primary screening will save an estimated 400 cervical cancer diagnoses every year so any delays to roll out could result in diagnoses which could have been prevented.
The HPV test, which was first approved in 2014, uses cervical and vaginal secretions to check for the presence of HPV. Additionally, they could not be diagnosed with invasive cervical cancer or have received a total hysterectomy. 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. About 4,200 women will die of the disease.
The researchers reported that there were fewer cases of precancer in the HPV test group, compared with the Pap smear group. Both groups were tested again using both methods after four years. Women who originally had the Pap smear were more than twice as likely to have abnormal cells. They also found that the HPV test was a better predictor of women who would be cancer free in future compared to Pap test.
In the United Kingdom, women are initially tested for abnormal cells before further checks reveal if they need further treatment for HPV. He wrote in an email that this new study actually shows the small but significant benefit of co-testing. According to the study, this method is recommended for the women aged thirty and above.
Of note, the Canadian Task Force on Preventative Health Care differs from the US task force - it recommends Pap smear screening every three years between ages 30 and 69, citing weak evidence for screening women ages 25 to 29. This is why most women still choose both of them.
Medical students learn how to insert a speculum, part of the process of performing a Pap smear. But because the HPV test is more sensitive to these abnormal cells, it could result in more women with positive rates resulting in a need for more colposcopies and biopsies, something the authors say could have unintended harm and increases in health care costs.