HPV better than Pap smear for picking up precancerous changes cervix
HPV better than Pap smear for picking up precancerous changes cervix
A new study found that the HPV test was better than the Pap smear in detecting precancerous changes that can lead to cervical cancer
07 July, 2018, 22:03
Almost all cervical cancer cases are linked to HPVinfection, and HPV testing detected pre-cancers earlier and more accurately than the Pap test among the 19,000 women in the Canadian study.
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 MI.
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. Organisations that develop cancer screening guidelines are wrestling with whether to recommend replacing co-testing with primary HPV testing as the optimal screening strategy. "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". Since all women who received a Pap smear at the end of the study, additional cases of early cancer were also detected.
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.
According to American College of Obstetricians and Gynecologists (ACOG) women aged 21 to 29 years should have a Pap test every three years while women aged between 30 to 65 years should have a Pap test along with a HPV test every five years or a Pap test every three years.
Most cervical cancers are caused by a particular strains of the Human papillomavirus, or HPV. 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.
In the United States, the conventional Pap smear has been largely replaced by a liquid-based Pap cytology test.
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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. Thus, the test is widely utilized in the early detection of pre cancers and cervical cancers. "They usually take up to 10 years to progress to cancers, but the point is if you don't find them, and you don't know how long they've been there, there is a chance that they could progress to the invasive form of cervical cancer". 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.
After four years it was found that nearly six women in 1,000 who had been screened as negative with Pap test alone had pre-cancerous lesions while two women in 1,000 with negative HPV testing showed precancerous lesions.
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. He wrote in an email that this new study actually shows the small but significant benefit of co-testing.
Pap smears involve scraping cells from the cervix and examining them for cancerous changes, also known as "cytology" testing.
'This can mean that women may need to be screened less frequently but have more accurate results.' There are about 3,000 cases of cervical cancer in the United Kingdom every year, leading to around 850 deaths.
Dr. Gina Suzanne Ogilvie of the Women's Hospital and Health Center in Vancouver and colleagues set up a comparison study.
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. More than 4,000 women die from it, even with screening and treatment.
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