Best-Way to Screen for Cervical Cancer

HPV16 and HPV18 detected more with HPV testing than cytology

(RxWiki News) Pap smears may soon become only a back-up screening for cervical cancer. New research shows one type of test may be best for ruling out the disease.

Human papillomavirus (HPV) testing that looks specifically for the most dangerous strains of the virus -  HPV16 and HPV18 - is most effective at detecting precancerous lesions that can lead to cervical cancer.  Newly published research found this testing is not only far better than pap smears, but that combining the two tests offers little benefit.

"Ask your gynecologist to test for HPV16 and HPV18."

HPV16 and HPV18 are responsible for roughly 70 percent of cervical cancers.

The findings suggest that HPV testing for these strains may be the most efficient primary screening tool. Pap smears could then be used to help determine if a woman needs a more thorough exam called a colposcopy. 

It's well known that HPV DNA testing is superior to pap smears for detecting the presence of cervical cancer. However, the best way to proceed in treating women with positive tests has not been established.

Up until now, tests to detect HPV16 and HPV18 have been used to determine the seriousness of lesions in women who tested positive for HPV. Results were used to see if a woman needed a coloscopy, which carefully examines any abnormalities found in the vulva, walls of the vagina or cervix (head of the uterus).

For this study called the ATHENA trial, researchers enrolled more than 47,000 women aged 25 and older who had routine screenings between May, 2008 and August, 2009. All samples received both conventional cytology and HPV testing.

Nearly twice as many high-grade precancers were detected in women who had HPV testing (92 percent) compared with women who were given cytology (53.3 percent).

Combining HPV testing with the pap smears - which is currently recommended -  didn't offer much benefit.

The findings of the study were published Online First in The Lancet Oncology