THURSDAY, Dec. 15 (HealthDay News) - To catch cervical cancer or
the lesions that can lead to it, a human papillomavirus (HPV) test
is the best option for women over 30, Dutch researchers report.
Using it in conjunction with the more traditional Pap smear
resulted in earlier detection of precancerous lesions and prevented
more cervical cancers from developing, said study author Dr. Chris
Meijer, a professor of pathology at VU University Medical Centre in
The study is published online Dec. 15 in
The Lancet Oncology.
Nearly all cervical cancers are caused by HPV, a virus spread
through sexual intercourse. Some HPV strains are more strongly
linked with the cancer than others.
The superiority of HPV testing over traditional Paps at finding
precancerous cervical lesions is established, Meijer noted.
However, his team wanted to see if HPV testing also offered better
protection and detection long-term -- in two screenings done over a
They found it did.
While five years may sound like a long lag time between
screenings, it is not, he said. "The Netherlands already has a
screening interval of five years, starting from 30 years of age
until 60 years," he said. The program is inexpensive and effective,
In the study, Meijer's team evaluated nearly 45,000 women, aged
29 to 56. Women in one group got a traditional Pap smear and an HPV
DNA test. The women in the other group got just the Pap test.
Five years later, all women got both tests.
The researchers looked to see whether HPV tests resulted in
fewer high-grade cervical lesions and cervical cancer in the second
screening, due to earlier detection and treatment.
In the first screen, the HPV tests found more of the early
changes that can precede cervical cancer than the Pap smear alone
Five years later, far fewer women in the HPV group had more
advanced lesions or cervical cancer than did the Pap-only
Four women in the HPV/Pap group were diagnosed with cervical
cancer, while 14 in the Pap-only group were.
When they looked at cervical cancer or advanced lesions, 88 in
the HPV arm of the study were diagnosed with one or the other
compared to 122 in the Pap-alone arm.
The improved protection against advanced lesions, the
researchers said, is due to the earlier detection of the precursor
lesions. When they were treated, it helped prevent them from
In an accompanying commentary, scientists from the U.S. National
Cancer Institute wrote that the Dutch trial does show the five-year
screening interval is safe. But they added that it is unclear if
the same results would hold true in a different population with
different testing guidelines.
The HPV test can be done using the same specimen collected for
the Pap test, Meijer said.
Costs of the tests differ. Meijer said Pap smears are about $38
in the Netherlands, while an HPV test costs about $64. However, the
Dutch Minister of Health recently recommended lowering the cost of
an HPV test to below that of the traditional Pap.
The new study is "further defining how we can incorporate HPV
testing into our screening program," said Dr. Elizabeth Poynor, a
gynecologic oncologist and pelvic surgeon at Lenox Hill Hospital,
in New York City.
She noted that she doesn't think the HPV screen will replace the
Pap test completely. "It may turn out to be a first-line screen.
Stay tuned for more," she said. "Certainly ask your physician if
you've had HPV."
In October, three U.S. cancer groups proposed new guidelines for
cervical cancer testing, extending intervals between screenings and
making other changes. These guidelines, issued by the American
Cancer Society and others, call for combination HPV/Pap smear
testing for women aged 30 and older.
After three normal Paps, women over 30 can have the test ever
two to three years, according to the American Cancer Society.
However, the U.S. Preventive Services Task Force remains
cautious about the use of the HPV test, standing by the Pap as the
best bet for now.
The Dutch study was funded by Zorg Onderzoek Nederland (the
Netherlands Organization for Health Research and Development).
To learn more about cervical cancer, visit the
U.S. National Institutes of Health.
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
Copyright © EBSCO Publishing. All rights reserved.