HPV test beats pap long-term: study

July 30, 2012 By Kathleen Doheny, HealthDay Reporter in Cancer

HPV test beats pap long-term: study

Finding lends support to current guidelines combining tests among women over 30.

(HealthDay) -- Testing for HPV, the human papillomavirus linked to cervical cancer, can predict which women will stay cancer-free for a decade or more, a new study shows.

While both a positive and an abnormal result on a traditional predicted which women would get within two years of testing, the HPV continued to predict which women were at risk for 10 to 18 years later, said study co-author Dr. Attila Lorincz, a professor of molecular epidemiology at Queen Mary University of London.

"HPV DNA testing detects more cervical precancers than the Pap test, and women who are negative for high-risk HPV DNA have improved protection from the risk of cervical cancer," Lorincz said.

The study, which looked at nearly 20,000 women receiving routine Pap tests and HPV testing at Kaiser Permanente in Portland, Ore., is published in the July 30 issue of the .

The research does not suggest one test should replace the other, Lorincz stressed, but confirms the importance of both screenings. The main aims of the study, he said, "were to see how many extra cases of precancer can be discovered by the additional use of HPV as compared to routine Pap testing."

The findings, he said, support recently revised guidelines suggesting that HPV testing, if negative, can allow for longer intervals between Pap testing for women over the age of 30. The findings also suggest that an alternate strategy, using HPV testing first, may work well, the researchers said.

According to guidelines, the preferred screening for healthy women aged 30 to 65 is to do a Pap and HPV test every five years. Women under 30 are often infected with HPV, but clear it spontaneously. That is why the guidelines for the roles of HPV and Pap testing combined are for women aged 30 and older.

As more research is done, guidelines may change, said study co-author Dr. Andrew Glass, senior investigator at Kaiser Permanente Center for Health Research. "It is likely that HPV testing will be more and more common and may in the future replace routine Pap testing," he said.

Both the Pap test and the HPV test are done on samples of cells taken from the cervix. The Pap detects cell changes on the cervix that could become cancer if not treated appropriately.

HPV tests look for DNA, or genetic material, of the virus that can lead to precancerous changes.

In the study, women over 30 with a positive HPV at the start were more likely to have a precancer or cancer during the 10- to 18-year follow-up than those who had an abnormal Pap.

Women who tested positive for the two strains of HPV most strongly linked with cervical cancer were more likely to have precancer during the follow-up than HPV-negative women, regardless of their initial result.

Having a negative HPV more strongly predicted who would remain cancer-free than the Pap did, the investigators found.

The researchers also looked at the effect of lengthening the screening interval from three years to five in women over 30 who had negative HPV and normal Pap tests. Doing this did not increase the risk of precancer and cancers appreciably.

Both tests are commonly covered by insurance plans, sometimes requiring a co-payment. The typical cost for each test is about $40 to $70, according to Lorincz.

The study finding "confirms the fact that you don't have to do a Pap smear every year in healthy women over 30," said Dr. Mark Wakabayashi, director of the division of gynecologic oncology at the City of Hope, in Duarte, Calif.

However, he stressed the importance of checking in with a doctor. "But you have to talk to someone who understands who does need a yearly Pap," he said. "This [finding] applies just to healthy ."

The findings have nothing to do with whether you received the HPV vaccine or not, Wakabayashi said. "A lot of people are thinking if they had the vaccine they don't need a Pap smear. Not true," he said. While the HPV vaccine aims to protect against , screenings are still crucial.

Study leader Dr. Philip Castle, of the American Society for Clinical Pathology, does consultant work for Merck, which makes an HPV vaccine. Lorincz is a consultant for, and owns stock in, Qiagen, which makes HPV tests.

More information: To learn more about screening for cervical cancer, visit the U.S. Centers for Disease Control and Prevention.

Journal reference: Journal of Clinical Oncology search and more info website

Copyright © 2012 HealthDay. All rights reserved.

not rated yet  

Rank not rated yet
Relevant PhysicsForums posts

More news stories

Study of young Israelis emphasizes need for avoidance of sun exposure for the very young

A new study conducted using extensive medical records of over one million Israeli adolescents before military service shows clearly how exposure to the Israeli sun of young, light-skinned children increases substantially ...

Cancer created 1 hour ago | popularity not rated yet | comments 0

Genetic diversity within tumors predicts outcome in head and neck cancer

A new measure of the heterogeneity – the variety of genetic mutations – of cells within a tumor appears to predict treatment outcomes of patients with the most common type of head and neck cancer. In the May 20 issue ...

Cancer created 5 hours ago | popularity not rated yet | comments 0

Molecular marker from pancreatic 'juices' helps identify pancreatic cancer

Researchers at Mayo Clinic have developed a promising method to distinguish between pancreatic cancer and chronic pancreatitis—two disorders that are difficult to tell apart. A molecular marker obtained from pancreatic ...

Cancer created 5 hours ago | popularity not rated yet | comments 0

New smartphone application improves colonoscopy preparation

The use of a smartphone application significantly improves patients' preparation for a colonoscopy, according to new research presented today at Digestive Disease Week (DDW). The preparation process, which begins days in ...

Cancer created May 19, 2013 | popularity not rated yet | comments 0

Research examines new methods for managing digestive health

Research presented at Digestive Disease Week (DDW) explores new methods for managing digestive health through diet and lifestyle.

Cancer created May 19, 2013 | popularity not rated yet | comments 1


Vitamin D could provide new and effective treatments for asthma

(Medical Xpress)—Scientists at King's College London have discovered that Vitamin D has the potential to significantly reduce the symptoms of asthma. The study, led by Professor Catherine Hawrylowicz from ...

Rethinking treatment goals improves results for 'untreatable' anorexics

(Medical Xpress)—Patients with the most severe and dangerous form of chronic anorexia are more likely to make a significant improvement towards recovery and stay in therapy if traditional psychological treatments are re-focused ...

Rise in type 2 diabetes amongst young

The number of young people diagnosed with type 2 diabetes has seen the sharpest rise over the last twenty years compared to a background of a general increase across the board, new University research has ...

Pre-proceedings process fails to reduce length of care proceedings, but can help divert cases from court

A major new report on a procedure that aims to reduce the duration of care proceedings for children has found it made no significant difference to what happened in court, and cases lasted just as long regardless of whether ...

Report reveals impact of public injecting

New research undertaken on the streets of Richmond and Abbotsford has revealed increasing health risks for people who inject drugs and significant community concern over the impact of injecting in public ...

Wireless ultrasound transducers help physicians

Siemens has presented the world's first ultrasound system with wireless transducers. The system's transducers, which can be easily operated with one hand, transmit ultrasound images via radio waves to the ...