New test beats Pap smear in study

NEW YORK – A relatively new screening test was about twice as accurate as the traditional Pap smear at spotting cervical cancer, according to the first rigorous study of the test in North America.

The new test could replace the 50-year-old Pap in a matter of years, experts say. And there’s a bonus for women: They won’t need a screening test as often.

The HPV test, which looks for the virus that causes cervical cancer, correctly spotted 95 percent of the cancers. The Pap test, which checks for abnormal cells under a microscope, only found 55 percent, according to researchers at McGill University in Montreal, who published their findings in today’s New England Journal of Medicine.

HPV, or human papilloma virus, is a common sexually transmitted disease. Infections are mostly in young women and most go away on their own. The HPV test looks for the high-risk viruses that can cause cervical cancer if the infection persists. Like the Pap, it uses cells scraped from the cervix, the lower part of the uterus.

Because the Pap test misses about half of the cases, doctors use frequent testing to catch the slow developing cancer at its earliest, most treatable stages.

The HPV test has been available in the U.S. since 2000 and was first used for inconclusive Pap tests. Now women over 30 can get a HPV test – but only along with a Pap – and wait three years to be tested again if both tests are negative.

More recently, scientists have been studying whether the HPV test can be used alone and whether it can prolong the intervals between exams. Debbie Saslow, director of breast and gynecologic cancer for the American Cancer Society, said evidence from a number of studies supports using the HPV test in place of a Pap.

“Overall, I don’t think there’s any doubt that HPV testing has a lot of advantages over the Pap test,” she said.

Saslow said there are still issues to be resolved, and federal approval needed, but “it’s definitely coming.” She said experts expect that to happen sometime in the next decade.

A Swedish study also in the journal compared Pap with HPV testing to Pap alone in 12,527 women in their 30s. They found the combo test detected precancerous lesions or cancer earlier than the Pap test alone.

The Canadian study, which was government-funded, included 10,154 women ages 30 to 69 in Montreal and St. John’s, Newfoundland. The American Cancer Society estimates that 11,150 cases of invasive cervical cancer will be diagnosed in the U.S. this year, and 3,670 women will die from the disease.