Virus testing better than Pap test for cervical cancer screening

Human papilloma virus (HPV) tests are much more efficient at detecting potential cervical cancers than traditional Pap tests, according to a large pilot study published in the journal PLOS Medicine.

The study, led by Karen Canfell of Cancer Council New South Wales, Australia, used almost 5000 cervical samples from women aged between 25 and 64 and subjected them to a randomised series of tests, ranging from standard Pap smears (a strategy known as cytology) to partial genotyping of the HPV virus.

The HPV tests detected significantly more precancerous anomalies than the Pap smears – with the Pap cohort returning a positive response in 2.7% of cases, compared to 3.8% in the HPV test group.

The finding comes as Australia prepares to change its cervical cancer screening regime from recommending Pap smears every two years to HPV tests every five.

“This adds to existing evidence about how much more effective HPV screening is,” says Canfell.

“We now have a superior method for detecting high-grade cervical precancerous abnormalities – this will provide increased protection to women against developing invasive cervical cancer later in life.”

The results are welcomed by Annika Antonsson of the Cancer Control Laboratory at the QIMR Berghofer Medical Research Institute in Queensland, Australia, who was not involved in the study.

“They found that these pre-cancerous cell changes were identified at much higher rates in the groups that were tested for HPV compared to the groups that were tested with Pap smears, regardless of whether they were offered HPV vaccination or not,” she says.

Margaret Heffernan, behavioural researcher on HPV vaccines at RMIT University, also praises the study, but calls for more research.

“It is piloting the HPV test for quality assurance and safety in a sample that includes women who have received the HPV vaccine,” she says.

“The study found higher detection rates that confirm the viability of introducing the test as a replacement for the current Pap test.”

She urged further testing, however, to confirm the efficacy of the approach across a broader range of women, especially “women from vulnerable and therefore high-risk populations”.

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