Published: Thu, July 05, 2018
Medicine | By Tracy Klein

Study Suggests Pap Test's Days Could Be Numbered

Study Suggests Pap Test's Days Could Be Numbered

The randomized, controlled study - the kind of trial considered the "gold standard" of research - showed that the human papillomavirus test is more sensitive than the Pap smear, a widely used test that has been a standard part of women's preventive health care for decades but has drawbacks. Organisations that develop cancer screening guidelines are wrestling with whether to recommend replacing co-testing with primary HPV testing as the optimal screening strategy. This method involves the direct analysis of the papillomavirus or HPV of the human that results in ninety-nine percent of the cervical cancers. But when an infection persists, it can cause cellular changes that develop into precancerous lesions and, eventually, malignancies.

Massad has consulted with malpractice attorneys in cases alleging missed cervical cancer but declared he had no relevant financial relationships with industry.

Women who have a positive Pap test, generally get a colposcopy, which is an even closer examination of the cervix, vagina and vulva for signs of disease.

The study bolsters previous research that showed that HPV testing was superior to Pap tests.

The Pap test is a smear taken regularly to look for the changes that indicate cancer is developing on the cervix.

A new study published in the Journal of the American Medical Association could change that recommendation. These conditions can be treated before they progress to cervical cancer. "In most places that's not the case", Dr. Kathleen Schmeler, associate professor in gynecological oncology and reproductive medicine at the University of Texas MD Anderson Cancer Center, who was not involved in the study, told ABC news. "It's fantastic", she said.

The FDA approved the first HPV test in 2014, which tests vaginal and cervical secretions (which can be gathered with a swab) for the presence of the HPV virus.

Better HPV test preventing cervical cancer than Pap smear, according to the recent reports. At the end of the four-year study, the women were tested with both tests.

The researchers said their results show that "primary HPV testing detects cervical neoplasia earlier and more accurately than cytology", adding that it "detected significantly more CIN3+ and CIN2+ cases in the first round and significantly reduced CIN3+ and CIN2+ rates 48 months later". "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". For those final results, both groups were tested using both the HPV test and the Pap test.

Suboptimal specificity of the HPV test is still a limiting factor for widespread adoption of the test as a cancer screening tool, write the authors of the editorial, "especially among populations of young women who often carry HPV infections that regress without oncogenic effect". 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.

Spitzer said those three cases support the "small but significant benefit of co-testing". They recommend further studies to help researchers understand long-term clinical outcomes and cost-effectiveness across both tests. They could also get a Pap test every three years.

This means that women may need to be screened less frequently but have more accurate results. But when infections last longer, they can cause not only cervical cancer but also cancer of the anus and back of the throat, as well as cancer of the penis.

The United States Preventive Services Task Force, an independent panel that reviews the evidence of effectiveness for preventive services, now recommends the "co-testing" for signs of cervical cancer that other groups advocate.

The Task force states that for women aged between 29 and 65 HPV tests alone every five years can be the only screening test.

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