The new cervical cancer screening method is more accurate than vaginal smears

According to a study published in JAMA, a new method of screening for the risk of cervical cancer could replace the dreaded and uncomfortable cervical smear. Screening for cancer-related human papillomavirus (HPV), responsible for 99.7% of cervical cancer, has surpassed smear efficiency in women over 30 years of age.

HPV testing is a less intrusive method. Instead of a doctor scraping cervical back cells before visually inspecting them for signs of abnormality, an HPV test analyzes the cells found in vaginal and cervical secretions.

The researchers compared the four-year HPV test in a randomized trial of more than 19,000 Canadian women. At first, half of the women were tested for HPV and the other half a Pap test. Those who tested negative with the HPV test returned four years later. Those in the Pap group who had a negative test came back two years later for another and, if they were negative again, they returned at the end of the four year study. At the four-year mark, all women were tested using both methods.

"The primary HPV test of women detects precancerous lesions earlier, and more specifically than the Pap test," said the authors in a statement. As a rule, women who had a cervical smear were twice as likely to have abnormal cells; The HPV test resulted in 22 cases while the cervical smear had 52 women with abnormal cells.

It is possible that these results were skewed because women received both treatment options at the end of the study. Because the HPV test was more likely to detect pre-cancerous cervical lesions earlier in the study, these women were less likely to develop cancer of the cervix of the uterus. Like all women who have had a Pap test at the end of the study, other cases of early cancer have also been detected. However, the authors note that participants were highly educated and that rural and remote communities were not well represented.

As reported by NPR, it has been difficult to justify the replacement of the cervicovaginal swab with the HPV test because, until now, there has been no comparison of head-to-head. The study is important to inform screening methods since the American Cancer Society estimates that 13,000 American women will be diagnosed with cervical cancer and about 4,170 will die from it. But because the HPV test is more sensitive to these abnormal cells, it could result in more women with positive rates requiring more colposcopies and biopsies, which, according to the authors, could have unintended consequences and increase health costs.

Currently, the US Preventive Services Task Force recommends that women between the ages of 30 and 65 be tested for both Pap and HPV every five years.