Pap Tests Used More Than HPV For Cervical Cancer Screening

USA Todayon Thursday examined the reasons Pap tests remain the top cervicalcancer screening tool despite some recent studies that found humanpapillomavirus tests to be "superior" tools (Rubin, USA Today, 11/1). According to two studies published last month in the New England Journal of Medicine, HPV tests were more accurate than Pap tests in the detection of cervical cancer and precancerous changes in the cervix.

For one of the studies, Canadian researchers led by Eduardo Franco of McGill Universityperformed an HPV test and a Pap test on 10,154 women ages 30 to 69. TheHPV test detected 95% of cases in which participants had precancerouschanges in the cervix, compared with 55% for the Pap test, the studyfound (Kaiser Daily Women's Health Policy Report, 10/19).

According to USA Today,about 60 million Pap tests are performed annually in the U.S., and"switching to screening with only an HPV test would represent a seachange in women's health care." The "most obvious roadblock" towardgreater HPV testing in the U.S. is that a test manufactured by Digene is the only HPV test approved by FDA, and it is approved only to be used in conjunction with a Pap test or as a follow-up screening, USA Today reports.In addition, a clinical trial to prove that screening with the HPV testwill lead to lower mortality rates "might be prohibitively costly andtime-consuming," according to USA Today.

Someresearchers said that other reasons Pap tests remain the top cervicalcancer tool include malpractice concerns, marketing of Pap tests, andreluctance among many physicians and women to not use the Pap tests,according to USA Today. Walter Kinney, a cytologist at Kaiser Permanentein California, said that even if HPV testing were approved as astand-alone primary screening tool, convincing physicians and patientsof its efficacy would be a challenge (USA Today, 11/1).

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