Study Finds HPV Test Viable Alternative to Pap Smear

Study Finds HPV Test Viable Alternative to Pap Smear

The other group was screened using Pap cytology, the liquid-based test that has largely replaced the conventional Pap smear in the US.

The study results showed that the human papillomavirus test is more sensitive than the widely used but often flawed method of performing a regular Pap smear, and several experts are predicting a strong push to replace Pap smears with simple HPV testing. Over the past several years, as experts learned more about HPV's role in cervical cancer, most medical groups have recommended that women in the United States get both the HPV test and the Pap smear - a practice called "co-testing".

Canadian researchers led by Professor Dr. Gina Ogilvie (the School of Population and Public Health - University of British Columbia, Vancouver) found out that most of the cervical cancer cases are associated with HPV infection.

Numerous medical groups have said that before moving to HPV testing only, they needed to see clinical trial results - such as the kind provided by the new head-to-head study - to determine which test, over time, was better at detecting the precancerous changes. The control group had the traditional Pap test for their initial screening, while the test group had primary HPV screening - a test that looked for more than a dozen specific types of HPV most likely to cause precancerous lesions in the cervix.

It most commonly affects women aged between 25 and 50 and is the leading cause of cancer in women under-35.

Of note, the Canadian Task Force on Preventative Health Care differs from the USA 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. HPV tests are also referred HPV DNA tests, which is mainly a follow up test for the abnormalities detected during the Pap smear tests.

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.

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Doctors believe that the HPV test is more accurate, and is a better tool in earlier diagnosis, also increasing the time between screening.

The HPV test was more likely to pick up pre-cancerous cervical lesions earlier in the study, so the women in this group were significantly less likely to develop invasive neoplasia, or cervical cancer.

"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. "When we think about cervical cancer screening, we want to think about it in the framework of how do we get this test in the hands of all women?"

The researchers say the best way to prevent HPV is to receive the vaccine.

It's possible these results were skewed because women received both treatment options at the end of the study. "Most women and doctors are not willing to give up this additional impact", he added. 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.

Most cervical cancers are caused by a particular strains of the Human papillomavirus, or HPV. The researchers noted that even if the guidelines do change for women over 30, the Pap smear is still important for women ages 21-29.

Dr. Carol Mangione, a USPSTF task force member and UCLA professor of medicine says the method of testing comes second to being sure that all women, especially high-prevalence groups like black and Hispanic women, are able to get the testing they need. 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.

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