New Cervical Cancer Screening Method Is More Accurate Than Pap Smears

Speculum

For women between the ages of 30 and 65 who are at risk of contracting human papillomavirus, a promising test might be an alternative to the dreaded Pap smear.

"What our study shows is that by using HPV testing, we detect precancerous lesions earlier", says lead author Dr. Gina Ogilvie. Previous research has indicated that HPV testing alone or combined with a Pap smear is linked to increased detection of precancerous lesions in the first screening round, followed by a subsequent reduction in precancerous lesions.

In addition to finding more precancers in the initial screening, women who had the HPV test had a "significantly lower likelihood" of having precancer in the cervix when they exited the study four years later. Cervical cancer still affects more than 12,000 women in the USA every year and kills more than 4,000.

There's a vaccine that prevents most cancer-causing strains of HPV, but once a person has become sexually active, it's too late to get it.

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. 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.

Schmeler often works in Latin America where, in countries like El Salvador, cervical cancer is one of the most common cancers in women primarily due to poor screening programs. Women with negative Pap smear results received a second Pap smear after 24 months. The researchers observed that women who were HPV-negative at baseline were significantly less likely to have CIN2+ or CIN3+ at 48 months compared with those who had negative Pap smear results at baseline. Altogether, 17% of the variation in genetic testing rates could be explained by surgeons' practice patterns, the study found.

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"This is one study", he said. The Canadian task force does note that HPV testing may be recommended once more research is available.

Because the HPV vaccine that is recommended for adolescents is still limited in its use, testing for the presence of the HPV virus, in general, will continue to be a crucial part of cervical cancer prevention. Effect of screening with primary cervical HPV testing vs cytology testing on high-grade cervical intraepithelial neoplasia at 48 months [published online July 3, 2018].

The researchers compared people who had the HPV test, the Pap smear and both, and analyzed their impact over four years. The control group had the traditional Pap test and the test group had primary HPV screening. Out of the subjects who examined negative in the HPV test, just twenty-two had abnormal cells, whereas out of those who tested negative in the Pap smear, fifty-two women had abnormal cells.

"This supports the small, but significant benefit of co-testing". Additionally, they could not be diagnosed with invasive cervical cancer or have received a total hysterectomy. Rising geriatric population will also add fuel this market, as they will further demand for more cancer assays and tests and hence will contribute towards the growth of this market in future.

Most medical groups, including the American Cancer Society and the American College of Obstetricians and Gynecologists, recommend that women of average risk get both HPV tests and Pap smears every five years between age 30 and 65, though they say a Pap test alone every three years is an acceptable alternative. 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. This type of cancer is mostly caused by the human papillomavirus (HPV), in as much as 99% of all cases. 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.

Pap smears involve scraping cells from the cervix and examining them for cancerous changes, also known as "cytology" testing.

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