Co-Testing for Cervical Cancer is Best, But Not Perfect

HPV test is better than Pap smear at detecting precancerous cervical changes study says

An exam room at the National Institutes of Health in Bethesda Md

HPV test will provide accurate results of cervical cancer than Pap smear.

Ever since Georgios Papanicolaou developed his eponymous cervical smear in the 1940s, Papanicolaou (Pap) testing for cervical cytology is one of the most widely used cancer control interventions in the USA. These HPV viruses are sexually transmitted and can cause most of the anal cancers; many vulvar, vaginal and penile cancers; and some oropharyngeal cancers as well along with the cervical cancers. He said that physicians will have to make the choice between HPV testing and co-testing based on cost-effectiveness studies and their own discretion, while continuing to improve outreach for underserved and inadequately screened women to combat such high rates of cervical cancer.

According to The Washington Post, a large clinical "gold standard" trial published on Tuesday revealed that the test for HPV can detect precancerous changes of the cervix earlier and more accurately than the Pap smear. 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. The Pap smear worked, he said, only because women were tested often and because cervical cancer grows slowly.

Of note, the Canadian Task Force on Preventative Health Care differs from the USA 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. After four years, almost six women in 1,000 who had Pap tests had pre-cancerous lesions, compared with just two in 1,000 women who had HPV tests alone. Gynecologic oncologist Dr. Kathleen Schmeler at the University of Texas MD Anderson Cancer Center, said in a statement, "In our world, this study is going to be a pretty big deal, in a good way".

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. For those final results, both groups were tested using both the HPV test and the Pap test.

While the results of the study are encouraging and suggest that HPV testing could work well as a primary test in place of cervical smears, we do not have longer-term results to show whether it actually makes a difference to how many women get invasive cervical cancer or die of the disease. This method involves the direct analysis of the papillomavirus or HPV of the human that results in ninety-nine percent of the cervical cancers.

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Pap smears rely on the human eye to get results, says Dr. Diane Harper, a professor of medicine who researches HPV at the University of MI, "and it's far preferable to detect problems on a molecular level".

In the first round of screening at the start of the study, more cases of CIN3+ were found in women who had HPV tests (7 per 1,000 women) than women who had smear tests (4.4 per 1,000 women).

Most cases are preventable with screening the best way of catching it before it develops.

Pap smear tests are also referred as Pap test or smear test or cervical smear test, in which Pap smear is prepared by collecting cells from outer cervix opening of the uterus and endocervix. Some women might not even realize that they are being tested for HPV. Overall, approximately 35% of patients had an elevated risk of carrying a genetic mutation, but just 27% of women in the study received genetic testing, the article reported. 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. Fewer cases of precancer were found in the HPV group, since that group had already had more precancerous signs identified and treated.

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

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