HPV Tests Could Soon Make Pap Smears Obsolete For Early Cervical Cancer Detection

HPV test can be administered every five years, and catches more precancerous cells that traditional Pap smears.

hpv test, pap smear, cancer detection
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HPV test can be administered every five years, and catches more precancerous cells that traditional Pap smears.

According to The Washington Post, a large clinical “gold standard” trial published on Tuesday revealed that the test for HPV can detect precancerous changes of the cervix earlier and more accurately than the Pap smear.

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.

Many women who have HPV (usually acquired via sexual contact) eliminate it from their bodies within a year or two. However, repeated or persistent infections can cause cellular changes in the cervix, eventually developing into precancerous lesions which can become malignant.

According to NPR, The American Cancer Society claims nearly 13,000 women in the U.S. are diagnosed with cervical cancer annually and more than 4,000 women die from it even when they have access to regular screening and treatment. Almost all cases of cervical cancer are caused by HPV infections.

As reported by CBC News, the clinical trial was conducted in B.C. and consisted of 19,000 women randomly divided into two groups. The control group had the traditional Pap test and the test group had primary HPV screening. The HPV test found almost 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.

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,” and many medical doctors are urging this practice continue, like Dr. Dena Grayson, who brought it up on Twitter. However, other experts now say the Pap smear should be dropped in favor of regular HPV testing.

Lead author Dr. Gina Ogilvie is in favor of a shift from Pap smears to HPV testing.

What our study shows is that by using HPV testing, we detect precancerous lesions earlier. If women have a negative HPV test, they are significantly less likely to have a precancerous lesion four years later, meaning we can extend screening time.

While co-testing catches more precancerous cells, it also raises the incidence of false positives, points out Dr. Diane Harper, a professor of medicine who researches HPV at the University of Michigan. Harper notes that using both Pap smears and HPV testing can mean up to 30 percent of women could have a false positive. A false positive generally requires a biopsy during a colposcopy, with risks like bleeding, infection and pelvic pain, and incur unnecessary costs and fears for patients.