Cervical Cancer Detection: HPV DNA Testing May Be Better Than PAP Smears

DNA testing for HPV (human papillomavirus) in recent studies has been shown to be more effective in diagnosing cervical cancer than the traditional PAP smear test most women are familiar with receiving. HPV is a very common sexually transmitted disease that frequently does go away on its own. However, some HPV infections can also persist for many years and are found to be the primary cause of cervical cancer.

A recent 8 year study of 130,000 Indian women published in the April 2009 New England Journal of Medicine showed that a single round of HPV DNA testing was superior in significantly reducing advanced cervical cancer and death as compared to other methods of testing.

The most common method of testing here in the U.S. is the PAP test, named after Dr. Georgios Papanikolaou, where cells are scraped from the cervix and sent to a laboratory to view the cells under a microscope to determine if there are abnormalities. HPV testing is also done on cells collected from the cervix but instead checks for certain HPV infections that are known to be higher risk for cervical cancer.

Testing is recommended to be done yearly in women under the age of 30. If the last three test years have been normal, then women can reduce screening to every two-three years as long as they do not have other health problems that might increase their risk of cancer. Regular PAP tests have reduced the rate of cervical cancer deaths to less than 4,000 a year but HPV DNA testing could reduce this number even further.

For women under 30, HPV testing should not be used as a main screening tool since most HPV infections resolve without treatment. A positive HPV test would cause unnecessary concern or additional therapy so women under 30 usually don't usually have a HPV test done unless their PAP smear comes back abnormal. Women over the age of 30 are less likely to develop HPV infections and those that do are more likely to fall into the group of women having persistent infections. Since those over 30 who have positive HPV tests are more likely to develop cervical cancer, they should have further testing.

There is discussion about whether the HPV DNA test will replace PAP smears in the future. Currently there are reasons to use both tests for screening for cervical cancer. Dr. Kenneth Noller, past president of ACOG and chair of the department of obstetrics and gynecology at Tufts Medical Center predicts that with time, PAP smears will become less common in women over 30 as more doctors grow more accustomed to HPV DNA testing.

Source:

http://www.cancer.gov/cancertopics/types/cervical/

http://health.usnews.com/blogs/on-women/2009/04/07/will-hpv-test-replace-pap-smear-in-cervical-cancer-screening.html