Saturday, 22 September, 2018

Hundreds of women will be spared from cervical cancer with new test

A new study found that the HPV test was better than the Pap smear in detecting precancerous changes that can lead to cervical cancer A new study found that the HPV test was better than the Pap smear in detecting precancerous changes that can lead to cervical cancer
Melissa Porter | 07 July, 2018, 22:01

Testing for cancer-related human papillomavirus (HPV), which causes 99.7 percent of cervical cancer, outperformed the effectiveness of Pap smears in women over the age of 30. One group got the HPV test to screen for cervical cancer, almost all cases of which are caused by HPV, the most common sexually transmitted infection.

The other advantage is a need for testing less often.

In a emailed statement to CBC News, Dr. Jennifer Blake, chief executive of the Society of Obstetricians and Gynaecologists of Canada, said: "Our HPV guideline is still in development, however we are supportive of HPV ... testing becoming integrated into provincial cervical cancer screening programs". The control group had the traditional Pap test for their initial screening, while the test group had primary HPV screening - a test that looked for more than a dozen specific types of HPV most likely to cause precancerous lesions in the cervix.

Women can get a clear result from a simple HPV test and those who receive a negative result will be able to trust those results for several years, she says.

The HPV infection is the most common sexually transmitted infection and is usually eliminated by the immune system within a year or two.

Numerous medical groups have said that before moving to HPV testing only, they needed to see clinical trial results - such as the kind provided by the new head-to-head study - to determine which test, over time, was better at detecting the precancerous changes.

In an accompanying editorial, L. Stewart Massad, MD, of the Washington University School of Medicine in St. Louis, argued that cytology testing does not significantly improve the accuracy of HPV testing, but it does increase costs and false-positive results.

It's possible these results were skewed because women received both treatment options at the end of the study.

Most cervical cancers are caused by a particular strains of the Human papillomavirus, or HPV.

The cytology-based Pap smear involves looking for cancer or precancer cells by testing cells taken from a woman's cervix.

Better HPV test preventing cervical cancer than Pap smear, according to the recent reports.

"This information will help inform future cervical cancer screening guidelines and continue to decrease deaths from this preventable disease", added Schmeler, who was not involved in the study.

Referral rates for abnormal test results were 57 per cent in the HPV group compared with 30.8 percent who underwent standard screening.

Major driving factors for the growth of this market include, increasing prevalence of cervical cancers, increasing demand for advanced cancer diagnostics, increasing awareness about technological advancements in cancer testing and aging population. Some are still skeptical of relying on HPV testing alone, and co-testing, or using both the HPV test and a Pap smear, is still the standard.

They also cautioned that more work needs to be done to assess the economic consequences of changing the screening model. Women who originally had the Pap smear were more than twice as likely to have abnormal cells. By adding the Pap test to the HPV group, an additional three lesions were found.

In the United Kingdom, women are initially tested for abnormal cells before further checks reveal if they need further treatment for HPV.

"This supports the small, but significant benefit of co-testing". The vaccine is given to teens and young adults, but generations of women are still at risk of cervical cancer because HPV eventually infects most people at some point. They could also get a Pap test every three years.

The researchers reported that there were fewer cases of precancer in the HPV test group, compared with the Pap smear group. Partly because of that, he said, "we're a long way away from replacing the Pap smear".