Monday, 19 November, 2018

HPV test better at detecting cancer than a Pap smear

A new study found that the HPV test was better than the Pap smear in detecting precancerous changes that can lead to cervical cancer A new study found that the HPV test was better than the Pap smear in detecting precancerous changes that can lead to cervical cancer
Ben Pena | 07 July, 2018, 22:01

Human papillomavirus (HPV) testing as a primary screening method for cervical cancer resulted in fewer cases and a lower rate of precancerous conditions than traditional cytological screening, researchers found.

The lead author of the study, Dr. Gina Ogilvie, said in a statement, "What our study shows is that by using HPV testing, we detect precancerous lesions earlier".

The other advantage is a need for testing less often.

"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. While neither method was foolproof, the study found that women who originally had the Pap smear were more than twice as likely to have abnormal cells, the article reported.

The findings were published July 3 in the Journal of the American Medical Association.

In an accompanying editorial, L. Stewart Massad, MD, of the Washington University School of Medicine in St. Louis, argued that cytology testing does not significantly improve the accuracy of HPV testing, but it does increase costs and false-positive results.

More women were referred for colposcopy after HPV tests at the start of the study: 57 per 1,000 women compared with 30.8 per 1,000 women after smear tests - but the reverse was true at 48 months.

Yet almost a third of women aged 24 to 64 - 1.2 million - missed their cervical smear test in 2016/17, with just 72 per cent of those who qualify being tested, down from 75.7 per cent in 2011.

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A simpler way to test for cervical cancer is the HPV test, which is performed by directly testing for the human papillomavirus, or HPV, which causes 99 percent of cervical cancer.

About 13,240 new cases of invasive cervical cancer will be diagnosed in the United States in 2018, according to the American Cancer Society.

When it comes to cervical cancer screening, most women receive a cytology-based Papanicolau (Pap) smear, where cells are scraped from the back of the cervix. They focused mainly on moderate or severe changes to cervical cells (pre-cancerous changes) that could lead to 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.

The Pap test, used for over 50 years to spot the early signs of cervical cancer, may soon become a thing of the past, new research suggests. However, it looks like neither test was completely certain, as abnormalities were found in women from both groups who tested negative previously. Women in their 20s are advised to get Pap smears, not HPV tests, because the virus is so common that most would test positive for infections that would most likely clear up on their own. More than 4,000 women die from it, even with screening and treatment. According to the article, the researchers surveyed 5080 women treated for early-stage breast cancer by 377 surgeons in Georgia and Los Angeles between 2013 and 2015.

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.

Spitzer said those three cases support the "small but significant benefit of co-testing". They could also get a Pap test every three years.

'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. They recommend further studies to help researchers understand long-term clinical outcomes and cost-effectiveness across both tests.

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

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