Cervical cancer is among the easiest gynecologic cancers to prevent and there are two tests that can help detect the disease early – the routine Pap smear and testing for human papillomavirus or HPV. However, in a study published in the journal JAMA on Tuesday suggests that cervical HPV testing may be able to detect signs of cancer earlier and more effectively than Pap smear over a 48-month period, as reported in CNN. The findings are part of the Human Papillomavirus for Cervical Cancer screening trial, a publicly funded Canadian study.
The cytology-based Pap smear involves looking for cancer or precancer cells by testing cells taken from a woman’s cervix. Diagnosing diseases by looking at single cells and small clusters of cells is called cytology or cytopathology. Lead author of the study and professor at the University of British Columbia, Dr Gina Ogilvie, said, “There has been a significant body of evidence that shows that by including HPV testing – as co-testing with cytology – we could improve detection of precancerous lesions of the cervix.” She also added that the current study is next step showing that by using only HPV testing in a screening scenario, four years later, women who received HPV testing were less likely to develop precancerous lesions.
The new study involved 19000 women in the age-group 25 to 65 across British Columbia who had no history of invasive cervical cancer. The women were randomly assigned to one of two groups between 2008 and 2012. The participants were given questionnaire’s which included questions related to their HPV vaccination status, sexual health and sociodemographic status, among other factors. The researchers found that significantly more women showed signs of precancer cells in the first round of HPV testing compared with the Pap test group.
This means that women may need to be screened less frequently but have more accurate results. If the HPV test is negative, it gives more assurance that women will not develop precancer in the next four years. Dr Kathleen Schmeler, a gynaecologic oncologist at The University of Texas MD Anderson Cancer Center said, “The bottom line is that it could really potentially simplify how we screen women and have it been more effective and not quite as complicated and burdensome – and opens the door for doing just HPV testing which is actually what’s currently recommended by the World Health Organisation for countries that don’t have Pap testing capabilities.” Organisations that develop cancer screening guidelines are wrestling with whether to recommend replacing co-testing with primary HPV testing as the optimal screening strategy.