HPV screening better than Pap smears

Modesto Morganelli
Settembre 20, 2017

Previous estimates have suggested the new screening program would lower cervical cancer incidence and mortality by at least 20 per cent due to the more accurate test.

However until now it had not been tested among women with a high uptake of the HPV vaccine.

The study, led by Karen Canfell of Cancer Council New South Wales, Australia, used nearly 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.

Australian researchers have found that HPV testing is a better screening tool for potential cervical cancer than Pap smears.

In December, the national cervical screening program will move from two-yearly Pap tests to five-yearly HPV screening from age 25.

'This adds to existing evidence about how much more accurate and effective HPV screening is.

The women were screened, either using liquid-based cytology alone every 2.5 years, HPV testing followed by liquid-based cytology in women who tested positive for high-risk viral subtypes, or HPV testing with another type of cell analysis in the high-risk subtype women every five years.

"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".

Primary HPV screening looks for DNA from the human papillomavirus virus strains that cause the vast majority of cervical cancers.

"The results from this recent, randomised, controlled trial in Australia, conducted after vaccination has been implemented now for 10 years, gives us confidence that the decision being made to move to HPV DNA testing ... is a safe and appropriate change", said Professor Garland, who was also on the scientific advisory committee for the study.

The study found that compared to the Pap test, HPV screening "significantly" increased detection of high grade precancerous cervical lesions among those who had been vaccinated.

In an email, University of Canterbury Professor of cancer epidemiology Ann Richardson says: "The idea was to compare the groups with respect to referral for colposcopy (a procedure where the cervix is examined more closely), and pre-cancer detection rates".

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