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Pap smear, used over the past 50 years to detect early signs of cervical cancer, may soon be a thing of the past, according to a new study.
What will replace it? The test of the human papillomavirus (HPV). Nearly all cases of cervical cancer are related to HPV infection, and HPV tests have detected pre-cancers earlier and more accurately than Pap smears in 19,000 women. A Canadian study
. The HPV test also appeared to be superior in predicting who would remain without cancer, the researchers found. Women whose HPV testing showed that they did not have the infection were less likely to develop a precancerous lesion over the next four years, compared to women who performed the Pap smear. .
"All women of childbearing age should be screened for cervical cancer," said Dr. Gina Ogilvie, Principal Investigator at the School of Public Health and Diseases. populations of the University of British Columbia in Vancouver.
The lives of thousands of women were saved because the Pap smear detected cervical cancer in its early stages. But the most recent and accurate HPV test could replace Pap smear as a preferred screening test, Ogilvie
reported. UU They indicate both HPV testing and Pap smear, but studies have shown that the true benefit comes from the HPV test, he added.
According to the American College of Obstetrics and Gynecologists, women between the ages of 21 and 29 should have Pap smears only every three years.
Women between the ages of 30 and 65 should be tested for Pap smears and tested for HPV every five years, or Pap tests every three years.
But a new draft guidelines from the US Preventive Services Task Force. UU says the HPV test can replace a Pap test, Ogilvie said.
More specifically, the working group recommends an evaluation every three years with the Pap test alone or every five years with the HPV test alone for women aged 29 to 65 years.
In women under 25, vaginal smearing remains the norm, as many young women are infected with HPV, Ogilvie added
. Uterine cervix cancer is very rare in younger women, and an HPV test could send many women to unnecessary treatments, he explained.
In the study, the researchers randomized more than 19,000 women aged 25 and over to a Pap test or an HPV test alone. After 4 years, almost 6 out of every 1,000 Pap smear patients had pre-cancerous lesions, compared to only 2 in 1,000 women who completed the HPV test alone.
The results appear in the July 3 issue of the Journal of the American Medical Association.
An expert predicts Pap smear will be out of phase in favor of HPV testing.
"The cervical smear will go away," said Dr. L. Stewart Massad, professor of obstetrics and gynecology at the University of Washington School of Medicine in St. Louis [19659017]. This trial showed that tests using HPV tests led to early diagnosis of cervical pre-cancer, and detected cases that Pap smear had missed, he said.
"Be alert to changes in the evaluation guidelines that promote HPV testing against Pap smear, and wait for a change in the longer interval between assessments," said Massad, author of a editorial published with the study. 19659002] But Dr. Jason Wright, Chief of Gynecologic Oncology at the New York-Presbyterian Medical Center at Columbia University in New York, is not ready to opt for the only screening test HPV.
"It's a study," he said. The Pap smear has been available for about 50 years, so joint testing remains a viable option, said Wright
. "But we will gradually move to more HPV testing for primary assessment," he said. "It's probably a slow process."
Women should discuss the risks and benefits of each test with their doctor, Wright advised.
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