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Evidence grows that an HPV screen beats a Pap test at preventing cancer

Switching to a human papillomavirus test may help reduce cases of the disease.

GUILTY AS CHARGED Human papillomavirus (shown) — especially types 16 and 18 —is responsible for nearly all cases of cervical cancer.


Evidence continues to grow that screening for human papillomavirus infection bests a Pap test when it comes to catching early signs of cervical cancer.

In a large clinical trial of Canadian women, pap tests more often missed warning signs of abnormal cell growth in the cervix than did HPV tests, researchers report July 3 in JAMA. As a result, at the end of a four-year period, researchers found 5.5 new cases of severely abnormal, precancerous cervical cells per 1,000 women who got Pap tests, compared with 2.3 cases per 1,000 women who got HPV tests. Pap tests are the standard way to screen for cervical cancer.

“We should be moving away from screening with Pap tests toward screening with HPV tests,” says L. Stewart Massad, a gynecologic oncologist at Washington University School of Medicine in St. Louis, who wrote a commentary accompanying the study.

Previous research has found HPV testing leads to increased detection of abnormal cervical cells before they become cancerous compared with a Pap test. For instance, a 2009 study reported fewer cases of advanced cervical cancers and fewer deaths among women in India tested for HPV (SN: 4/25/09, p. 11). The study supported HPV testing in poorer countries, where cervical cancer screenings aren’t widespread. Worldwide, cervical cancer ranks fourth deadliest for women.

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