Best Test for Predicting Cervical Cancer

Cervical cancer risks predicted with HPV testing

(RxWiki News) If you've been following the changing guidelines for women's health maintenance, you will know that annual Pap smears are no longer recommended for cervical cancer screenings. A new study has found which test is best for predicting cervical cancer risks.

Human papillomavirus (HPV) DNA testing is more accurate than Pap smears in predicting cervical cancer risks, especially in women over the age of 30.

"Talk to your gynecologist about cervical cancer screening."

The study was led by co-author, Attila T. Lorincz, PhD, professor of molecular epidemiology at Queen Mary University of London.

The study involved 19,512 women who were screened for cervical cancer using both methods for between 10 and 18 years.

The study participants were given an HPV test. Those who were found to have the virus were then tested for HPV16 and HPV18, the two subtypes linked to cervical cancer. Annual Pap smears were also given for up to 18 years of follow-up.

The team was looking for the incidence of either serious pre-cancers (grade 2 and 3 cervical intraepithelial neoplasia - CIN2+ and CIN3+) or cervical cancer.

Of the total group, precancerous lesions were detected in 595 women. That means  0.030 women in the study were at risk of developing precancerous cervical lesions over a 10-18 year period. 

Researchers found that a negative HPV test was more accurate than a normal Pap smear in predicting who would develop cervical cancer over the next 18 years. Baseline (beginning) Pap smears and HPV testing predicted the likelihood of CIN3+ in the next two years. 

HPV testing detected a total of 14.2 percent of women who had the virus, compared to 5.4 percent of the women who had positive Pap smears.

The authors concluded, "HPV testing to rule out cervical disease followed by Pap testing and possibly combined with the detection of HPV16 and HPV18 among HPV positives to identify those at immediate risk of CIN3 would be an efficient algorithm for cervical cancer screening, especially in women age 30 years or older."

This study, which was supported by the National Cancer Institute, was published July 30 in the Journal of Clinical Oncology.

One of the authors, Philip E. Castle, PhD, of the American Society for. Clinical Pathology, has a financial relationship with Merck, a manufacturer of an HPV vaccine. Dr. Lorincz has financial ties to Qiagen, which manufactures an HPV test.

Review Date: 
August 6, 2012