Sources: The Lancet; US Preventivie Serivices Task Force; WebMD

It appears that way.  It is largely accepted that 90% of all cervical cancers are caused by the Human Papillomavirus (HPV).  Accordingly, a team of Dutch researchers set out to determine whether detecting the cause of the majority of cervical cancers could out-predict the traditional test.  45,000 women from ages 29 to 56 were screened using both the Pap (Papanicolaou) test and the HPV test.

Curiously, both self-sampling (women testing themselves at home) and high-risk HPV testing were found to be almost 3x as sensitive as Pap-smear cytology for detection of biopsy-verified grade 2 and 3 CIN lesions in postmenopausal women.  This led researchers to conclude that HPV testing in women aged 50—65 years old might reduce cervical cancer incidence by almost 50%.  In women over 50 years, the identification of cervical cancer is often delayed and diagnosed at a more advanced stage. Therefore, the prognosis is worse, which further supports a change to a more sensitive screening method.
The study recommends starting women with HPV testing at age 30 and continuing along with Pap smear testing to reduce cervical cancers.  Why is this study so important?  Because the U.S. Preventative Task Force (USPSTF)currently only recommends that women between ages 21 and 65 receive Pap smear testing every 3 years and does not recommend HPV testing based on “insufficient evidence.”  New cervical cancer screening guidelines (The prior ones went into effect in 2003!) are expected to be made final in the coming year -2012.  This study might lend weight to adding HPV testing for cervical cancer.
The USPSTF’s Current Recommendations for cervical cancer screening are:
  • The USPSTF strongly recommends screening for cervical cancer in women who have been sexually active and have a cervix.
  • The USPSTF recommends against routinely screening women older than age 65 for cervical cancer if they have had adequate recent screening with normal Pap smears and are not otherwise at high risk for cervical cancer.
  • The USPSTF recommends against routine Pap smear screening in women who have had a total hysterectomy for benign disease.
  • The USPSTF concludes that the evidence is insufficient to recommend for or against the routine use of new technologies to screen for cervical cancer.
  • The USPSTF concludes that the evidence is insufficient to recommend for or against the routine use of human papillomavirus (HPV) testing as a primary screening test for cervical cancer. 

Perhaps this study will be the first of many which leads the USPSTF to conclude otherwise.

Posted by: David M. Schwadron, Esquire