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 Negative HPV tests provided women with more reliable assurance that
they wouldn’t develop cancer or other abnormal cervical changes in
the next three years, compared to traditional Pap tests, researchers
report.
“Primary HPV screening might be a viable alternative to Pap
screening alone,” said Julia Gage, the study’s lead author from the
National Institutes of Health’s National Cancer Institute in
Bethesda, Maryland.
About 12,000 U.S. women were diagnosed with cervical cancer in 2010
and about 4,000 died from the disease, according to the Centers for
Disease Control and Prevention. Roughly 91 percent of cervical
cancers are thought to be caused by HPV.
Pap smears, which require doctors to collect cells from the cervix
to look for abnormalities, have traditionally been used to determine
whether a woman is at risk of developing cancer in the near future.
In 2012, the government-backed U.S. Preventive Services Task Force
recommended women between ages 21 and 65 years be screened using a
Pap test every three years and said those ages 30 to 65 years could
instead opt for cotesting, which is a Pap test in combination with a
HPV test, every five years.
HPV is the most common sexually transmitted infection and affects
both men and women. About 79 million people have the infection but
most people don’t know they’re infected because symptoms are
uncommon.
HPV testing also requires doctors to collect cells like they would
during a Pap test but the end result is whether the woman has the
virus - not abnormal cells.
“What we wanted to see is whether primary HPV screening could be a
good alternative to Pap and compare it to cotesting,” Gage said.
For the new study, the researchers used data from over one million
women who were between ages 30 and 64 years and screened for
cervical cancer at Kaiser Permanente Northern California since 2003.
The researchers followed women who had a negative Pap or HPV test to
see whether they developed cervical cancer during the next three
years. They also looked at how many women developed cervical cancer
in the five years following cotesting.
Overall, about 20 women out of 100,000 developed cervical cancer in
the three years following a negative Pap test. That compared to 11
women out of 100,000 who developed the cancer during the three years
after receiving a negative HPV test.
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About 14 women out of 100,000 developed cervical cancer in the five
years following negative cotests, according to results published in
the Journal of the National Cancer Institute.
Gage said the findings were not surprising, since HPV is the cause
of most cervical cancers.
She cautioned that the results do not foreshadow the death of Pap
smears. The tests may still have a role in monitoring whether women
with HPV, who are at an increased risk of cancer, go on to develop
abnormal cervical cells.
“We always have to reconsider how we’re screening patients and focus
on the best way to screen for certain cancer,” said Dr. Mario Leitao
Jr., a gynecological surgeon at Memorial Sloan Kettering Cancer
Center in New York City.
“I think this is very interesting because instead of doing (Pap
tests) every three years you could do HPV (tests) every three
years,” said Leitao, who was not involved with the new study.
He said there will be a lot of variables in deciding which test is
best for women.
“The best way to do it is still to be determined but it’s important
they have some form of cervical cancer screening at least every
three years,” Leitao said.
He added that women also have to be their own advocates and tell
their doctors that they don’t need Pap tests every year.
“It shouldn’t be done more frequently than every three years,” he
said.
SOURCE: http://bit.ly/UckC33 Journal of the National Cancer
Institute, online July 18, 2014.
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