For decades we have been using PAP smears as a screening method to detect pre cancerous changes in the cervix, usually caused by HPV( Human Papilloma Virus). For several years now HPV testing can be performed by taking a swab from the cervix ( or other affected area). Two recent studies published in Gynecologic Oncology, have reported that screening for HPV provides more accurate results for both HPV and cervical cancer. Even more accurate than the gold standard PAP smear.
The review was brought on after an application was made to the FDA to use a HPV test for primary cervical screening. A panel was convened and they looked at the safety and effectiveness of HPV screening. They found that in patients from the age of 25, that HPV testing performed better than a PAP smear alone. They recommended that HPV testing should be done on a 3 yearly basis. They felt that it would give more reassurance than a negative PAP smear. If on HPV testing the patient tests positive for one of the high risk strains, most notable 16 and 18 implicated in over 70% of cervical cancers, they should then be offered a colposcopy ( examination under microscope) as soon as possible. If they tested positive for one of the other 12 higher risk HPV strains they recommended retesting with an HPV test and a PAP smear, after 12 months. This type of screening method is already in use in other parts of the world.
In another paper published they looked at over 42000 women over the age of 25, who had both HPV testing and a PAP smear. They found that HPV testing was twice as likely to identify serious cases of cervical disease as the PAP did. In other age groups the tests performed equally well but there was still a cost saving as they only needed the one HPV test.
Dr Wright, professor Emeritus of Pathology and Cell biology at Columbia University in New York said that it was clear that the new screening strategy should be consider in all women aged 25 or
In my own practice I recommend HPV testing for all sexually active females and vaccination with Gardasil to prevent infection with the most at risk strains. It is a simple precaution that could very well save your life.