Published: Thu, July 05, 2018
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Study Finds HPV Test Viable Alternative to Pap Smear

Study Finds HPV Test Viable Alternative to Pap Smear

Nearly each type of cervical cancers is caused due to the infection by one of the 12 types of oncogenic human papilloma viruses (HPV).

The Pap test that has been used for decades as the standard in cervical cancer screening for Canadian women should be replaced by a test that detects high-risk types of human papillomavirus (HPV), a new study says. Generally speaking, women who had the Pap smear were more than twice as likely to have abnormal cells; HPV testing resulted in 22 cases whereas the Pap smear had 52 women with abnormal cells.

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. It was published this month in the Journal of the American Medical Association.

In the first round of screening at the start of the study, more cases of CIN3+ were found in women who had HPV tests (7 per 1,000 women) than women who had smear tests (4.4 per 1,000 women). Cervical cancer still affects more than 12,000 women in the US every year and kills more than 4,000.

"Most cases of cervical cancer happen in women who have not been regularly screened, or who have been screened, but don't have access to appropriate treatment", she says.

Geographically, North America dominates the Pap smear and HPV testing market followed by Europe.

Pap smears rely on the human eye to get results, she says, and it's far preferable to detect problems on a molecular level.

Even the most flawless tests can also be limited by the fact that not all women are receiving regular and timely screening.

This means that women may need to be screened less frequently but have more accurate results.

Currently, the US Preventive Services Task Force recommends women aged 30-65 receive both a Pap and HPV testing every five years.

"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. By adding the Pap test to the HPV group, an additional three lesions were found. 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 study inferred that HPV testing could be comparatively much more accurate.

The study documented the results of a randomized clinical trial comparing Pap smears with the use of HPV tests. Altogether, 17% of the variation in genetic testing rates could be explained by surgeons' practice patterns, the study found. Some women might not even realize that they are being tested for HPV. He called use of the HPV test only a "reasonable strategy" but noted that the test's strength - its sensitivity - could result in more positive results and more testing.

At present, as per the screening guidelines from the draft issued last fall by USPSTF, the tests supposed to be taken for every 5 years for HPV tests and 3 years for pap smear.

Moving away from co-testing may not be a good idea, according to Mark Spitzer, an OB-GYN and past president of American Society for Colposcopy and Cervical Pathology. As a result, the study's results are likely an underestimate, as underserved women were not included, although they may face the highest risk of developing cervical cancer, the authors said. Increasing awareness among the global population about the benefits associated with these type of tests such as pre cancer detection have also led to the increased number of procedures for testing cervical cancers across the globe. Additionally, they could not be diagnosed with invasive cervical cancer or have received a total hysterectomy.

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

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