A study from Canada found that an initial test for human papilloma virus (HPV), which causes nearly all cases of cervical cancer, led to the discovery of more pre-cancerous lesions than were found with conventional smear tests.
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".
Researchers recruited 19,009 women to have initial screening either by HPV test or smear test, with around half randomly assigned to each group.
In a emailed statement to CBC News, Dr. Jennifer Blake, chief executive of the Society of Obstetricians and Gynaecologists of Canada, said: "Our HPV guideline is still in development, however we are supportive of HPV ... testing becoming integrated into provincial cervical cancer screening programs". Those in the Pap group who tested negative returned two years later for another and, if they tested negative again, returned at the end of the four-year study.
Cervical cancer is very rare in younger women, and an HPV test might send many women for unnecessary treatment, she explained. Most sexually active adults contract HPV at some point, but it is usually cleared without problems.
But the study by Canadian researchers, published in the journal JAMA, found testing for HPV in the first instance had better results.
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Several experts predicted the results would spur efforts to entirely replace the Pap test with the HPV test. 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.
Might women over 30 soon be saying goodbye to the Pap smear?
A new study conducted by a team of researchers has revealed a yet simpler method to examine any condition of cervical cancer.
Referral rates for abnormal test results were 57 per cent in the HPV group compared with 30.8 percent who underwent standard 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.
Whether they receive a Pap test or an HPV test, the experience for patients is the same in their doctor's or nurse practitioners' office. Then four years later, both groups were tested using both methods, in order to see the results. "In fact, at the conclusion of the study, all HPV-negative women were tested with the Pap smear, which led to finding additional cases of pre-cancerous lesions".
"This supports the small, but significant benefit of co-testing".
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'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. Consistent with prior studies, more cases of abnormal cells in the cervix, known as cervical intraepithelial neoplasia (CIN), grade 3 or worse (CIN3+), were detected in the intervention group compared with the control group in the first round of screening.
Women should discuss the risks and benefits of each test with their doctor, Wright said.
Most cases are preventable with screening the best way of catching it before it develops. According to the study, this method is recommended for the women aged thirty and above. Two years later, the ones that tested negative after the Pap smear had another test of the same type.
Almost all cases of cervical cancer are caused by persistent infections of high-risk HPV, which causes changes to cervical cells.
Medical students learn how to insert a speculum, part of the process of performing a Pap smear.
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