Step aside, Pap smear. For the past six decades this has been the popular tool used to screen women for cervical cancer. But a new Danish study has provided compelling evidence that for older women, testing for the human papillomavirus (HPV) is more effective for finding out if an individual is at a high risk of developing cervical cancer.
These tumors are largely caused by an HPV infection, with two strands of the virus responsible for up to seven of every 10 cases of cervical cancer. Though younger women are at greater risk of getting infected (because it is most easily transmitted through sexual contact), infection later in life actually becomes a major risk factor for cancer.
The new research shows that getting one HPV test is better than one Pap smear during screening for cervical cancer. Researchers compared these two tests among more than 8,600 women between 22 and 32 years of age, and more than 1,500 women between 40 and 50. They collected cervical samples from all women to test for HPV, and all women had many Pap smears in the decade following the study.
Within 10 years, 21% of women whose Pap smear had come back negative for cervical cancer developed tumors or precancerous lesions. Now, for women, who tested negative on both tests, only 1.7% developed tumors or lesions. The older group of women had a greater than 20% chance of getting cervical cancer if they tested positive for HPV. All of these findings point to the same conclusion: the HPV test appears more relevant and effective for screening older female patients at risk.
At the moment, the American Cancer Society recommends that after the age of 30 women who have had three normal Pap smears in a row can cut back on these tests to getting one done every two or three years. Women over 30 can also opt to have both a Pap and an HPV test. If both are negative, it’s good news, and another round of tests is not needed for the next three years.
The Pap smear is still important, but in a way it shows what is going on today while the HPV tests predicts what will happen in the future — figuring out just who will develop cervical cancer. While the Pap test remains an effective cancer-screening tool, the HPV test will reveal long-term risks. A negative HPV test means nothing is likely up for at least five years, while a positive test, especially two in a row, says something is going on even if a Pap test came back negative.